How Much Does Circum 28 Days or Older Cost?
Also known as: Circum 28 days or older (CPT 54161)
Circumcision of an adult male.
The total estimated cost of Circum 28 Days or Older (CPT 54161) is $608 to $1,140, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $181.
Total Estimated Cost of Care
This estimate includes hospital facility fees, anesthesia, and supplies .
Patient Guide: Circum 28 Days or Older
What you need to know before your appointment
What to Expect
Under local or general anesthesia, the surgeon removes the foreskin from the penis. Stitches dissolve on their own.
How Long Does It Take?
30-45 minutes
Common Reasons Doctors Order This
Phimosis, recurrent infections, personal preference, religious reasons
How to Prepare
Fast if general anesthesia. Wear loose underwear after. Follow wound care instructions. Avoid sexual activity for 4-6 weeks.
Procedures Commonly Done Together
These procedures are frequently performed alongside Circum 28 days or older
How to Reduce Your Cost for Circum 28 days or older
Practical tips that can save you hundreds or thousands of dollars
- 1 Ask about cash-pay discounts
Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.
- 2 Compare facility vs. office setting costs
Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.
- 3 Shop around — costs vary significantly
Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.
How is the Price Calculated?
Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.
Payment = Total RVU (5.42) x CF ($33.40) = $181
Related Procedures
Similar procedures in the same category or body system
Frequently Asked Questions
How much does Circum 28 days or older cost?
The Medicare facility rate for Circum 28 days or older is $181. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).
How much does Circum 28 days or older cost without insurance?
Without insurance, the cost of Circum 28 days or older can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.
Does insurance cover Circum 28 days or older?
Most commercial health insurance plans and Medicare cover Circum 28 days or older when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.
Why does the cost vary so much by location?
Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.