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Billing code 54535: Radical orchiectomyMedicare rate & RVUs

Reports radical removal of a testis for tumor through an abdominal approach, including situations in which the affected testis is located intra-abdominally.

CMS RVU26DEffective Oct 1, 2026109 payment localities21 Medicare services in 2024

Medicare pays $673.70 for 54535 nationally in a facility.

Medicare rate · 54535

Radical orchiectomy

Work RVUs
12.86
Total RVUs
20.17
Global days
090

National rate · 2026

$673.70

Facility setting, before claim adjustments.

See every locality for 54535 →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 54535 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 54535 covers

A urologist performs this operation to remove a testis for a tumor through an abdominal approach, with dissection of the associated spermatic cord. It may be used when the affected testis is intra-abdominal. The operation is performed in an operating room and is more extensive than removing a localized testicular lesion or only part of the testis.

Choose this code based on the operative indication, the radical extent of removal, and the abdominal route documented in the operative report. The code has a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be 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 54535 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

54535 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$626.15
Alaska*Unavailable$876.01
ArizonaUnavailable$659.90
ArkansasUnavailable$620.31
AtlantaUnavailable$689.09
AustinUnavailable$679.24
BakersfieldUnavailable$678.46
Baltimore/Surr. CntysUnavailable$707.43
BeaumontUnavailable$652.77
BrazoriaUnavailable$663.31

54535 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
54535 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 54535 rate is calculated

Each of 54535’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 · 54535

RVUs × geographic indexes × conversion factor

Work12.86

12.86 RVUs× 1.000 GPCI

Practice expense5.66

5.66 RVUs× 1.000 GPCI

Malpractice1.65

1.65 RVUs× 1.000 GPCI

Adjusted RVUs

20.1700

Conversion factor

$33.4009

Medicare rate

$673.70

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 54535

54535 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 54535

Radical orchiectomy

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)2Paid.
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 · 54535

Radical orchiectomy

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned 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

54535 without 50 · national facility

$673.70

Radical orchiectomy

54535-50 · Bilateral: 150%

$1,010.55

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

54535 compared with similar codes

Compare codes · National

5 codes, side by side

  • 54535

    Radical orchiectomy12.86 wRVU

    Not priced

  • 54530

    Orchiectomy8.25 wRVU

    Not priced

  • 54520

    Testis removal5.17 wRVU

    Not priced

  • 54522

    Partial orchiectomy9.99 wRVU

    Not priced

  • 54512

    Testicular surgery9.1 wRVU

    Not priced

How to choose

54530Orchiectomy
Use 54535 for the abdominal approach to radical tumor removal. Use 54530 when the radical operation is performed through the inguinal approach.
54520Testis removal
This code describes radical tumor surgery by an abdominal approach; 54520 describes simple orchiectomy, not radical removal for tumor.
54522Partial orchiectomy
Use 54522 when only part of the testis is removed. Use 54535 when the operation is radical removal for tumor through the abdominal approach.
54512Testicular surgery
54512 is for excision of a testicular lesion. Choose 54535 when the documented operation is radical removal for tumor through an abdominal approach.

Codes related to 54535

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

Codes related to 54535
CodeHow it relatesNational office range
Used instead
54530OrchiectomyRadical removal for tumor through the inguinal rather than abdominal approach.No office rate
54520Testis removalSimple orchiectomy when the operation is not radical removal for tumor.No office rate
54522Partial orchiectomyPartial orchiectomy when only part of the testis is removed.No office rate
54512Testicular surgeryLocalized testicular lesion excision rather than radical orchiectomy.No office rate

54535 billing questions

How is this different from 54530?

Both describe radical removal for a testicular tumor. This code is for the abdominal approach; 54530 is for the inguinal approach.

When would a limited testicular excision be a better fit?

Use a limited excision code when the operation removes a localized lesion rather than the testis radically. The operative report should establish the extent of tissue removed.

What does the 90-day global period include?

It includes the day-before preoperative visit and 90 days of related postoperative care.

How is bilateral surgery reported?

CMS lists bilateral reporting with modifier 50, paid at 150%.

Can an assistant or another surgeon be reported?

An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted for this code.

What should the operative report support?

Document the tumor indication, abdominal approach, and radical extent of removal, including the side operated on.

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 54535PPRRVU2026_Oct_nonQPP.csv, line 6,314 (RVU26D)

Open CMS sourceHow we calculate rates

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