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Billing code 54520: Testis removalMedicare rate & RVUs

Reports simple surgical removal of a testis, including a subcapsular procedure, when the treatment plan calls for removal rather than biopsy or limited lesion excision.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.5K Medicare services in 2024

Medicare pays $305.62 for 54520 nationally in a facility.

Medicare rate · 54520

Testis removal

Swap in your local Medicare rate.

Work RVUs
5.17
Total RVUs
9.15
Global days
090

National rate · 2026

$305.62

Facility setting, before claim adjustments.

See every locality for 54520 → · Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

On this page 10 sections
  1. Medicare rate
  2. What 54520 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 54520 covers

A urologist typically performs this operation in a hospital or ambulatory surgery setting to remove a testis, including by a subcapsular technique. It may be selected when the testis is being removed for a condition not requiring the radical tumor operation represented by a different code. The code encompasses the simple removal whether the surgeon uses a scrotal or inguinal approach, and allows for removal with or without a testicular prosthesis.

Choose the code based on the operation documented, not simply the diagnosis or incision: the record should support removal of the testis and distinguish a simple procedure from partial removal, limited lesion excision, or radical tumor surgery. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral surgery, modifier 50 is paid at 150%. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 54520 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

54520 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$281.47
Alaska*Unavailable$388.07
ArizonaUnavailable$298.74
ArkansasUnavailable$278.49
AtlantaUnavailable$312.77
AustinUnavailable$309.48
BakersfieldUnavailable$309.79
Baltimore/Surr. CntysUnavailable$322.08
BeaumontUnavailable$294.12
BrazoriaUnavailable$300.66

54520 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
54520 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 54520 rate is calculated

Each of 54520’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 54520

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.17Practice expense 3.25Malpractice 0.73

9.1500 adjusted RVUs×$33.4009 conversion factor=$305.62

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 54520

54520 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 54520

Testis removal

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 54520

Testis removal

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

54520 without 50 · national facility

$305.62

Testis removal

54520-50 · Bilateral: 150%

$458.43

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

54520 compared with similar codes

Compare codes

54520 vs 54522 vs 54530 vs 54535 vs 54512: national Medicare rates

Swap in your local Medicare rate.

  • 54520
    Testis removal · 5.17 wRVU
    —
  • 54522
    Partial orchiectomy · 9.99 wRVU
    —
  • 54530
    Orchiectomy · 8.25 wRVU
    —
  • 54535
    Radical orchiectomy · 12.86 wRVU
    —
  • 54512
    Testicular surgery · 9.1 wRVU
    —

How to choose

54522Partial orchiectomy
54522 is for partial orchiectomy, with testicular tissue preserved; 54520 represents simple removal of the testis.
54530Orchiectomy
54530 is the radical operation for a testicular tumor using an inguinal approach. Do not select it solely because the diagnosis is a tumor; the documented procedure must support radical surgery.
54535Radical orchiectomy
54535 represents radical tumor surgery with abdominal exploration. A simple orchiectomy without that radical operation is reported with 54520.
54512Testicular surgery
54512 applies when a testicular lesion is excised and the testis is preserved; 54520 applies when the testis is removed.

Codes related to 54520

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 54520
CodeHow it relatesNational office range
Same family
54522Partial orchiectomyPartial orchiectomy when the operation removes only part of the testis.No office rate
Used instead
54530OrchiectomyRadical orchiectomy for a testicular tumor through an inguinal approach.No office rate
54535Radical orchiectomyRadical tumor surgery when abdominal exploration is also performed.No office rate
54512Testicular surgeryExcision of a testicular lesion when the testis is not removed.No office rate
54505Testicular biopsyOpen testicular biopsy for tissue sampling rather than testis removal.No office rate

54520 billing questions

How is 54520 different from radical orchiectomy 54530?

Use 54520 for simple removal, including subcapsular removal. Code 54530 describes radical orchiectomy for a tumor through an inguinal approach.

Can 54520 be reported for partial removal of a testis?

No. When only part of the testis is removed, compare the operative documentation with 54522, the partial orchiectomy code.

Is removal of a small testicular lesion coded as 54520?

Not when the surgeon excises a lesion while preserving the testis; compare 54512. Report 54520 when the operation removes the testis.

How should bilateral orchiectomy be reported?

Report bilateral surgery with modifier 50. CMS pays this bilateral procedure at 150%.

What postoperative care is included in 54520?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant surgeon or co-surgeon be reported?

CMS does not pay assistant-at-surgery services for this code. Co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 54520PPRRVU2026_Oct_nonQPP.csv, line 6,311 (RVU26D)

Open CMS sourceHow we calculate rates

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