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Billing code 54550: Testis explorationMedicare rate & RVUs

Surgical exploration to locate and assess an undescended testis, typically performed by a urologist when examination has not established its position.

CMS RVU26DEffective Oct 1, 2026109 payment localities17 Medicare services in 2024

Medicare pays $451.58 for 54550 nationally in a facility.

Medicare rate · 54550

Testis exploration

Swap in your local Medicare rate.

Work RVUs
8.2
Total RVUs
13.52
Global days
090

National rate · 2026

$451.58

Facility setting, before claim adjustments.

See every locality for 54550 → · 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 54550 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 54550 covers

This operation involves surgically examining the inguinal or scrotal area to locate and assess a testis that has not descended. A urologist commonly performs it in a hospital or ambulatory surgery setting, often for a child with a nonpalpable or abnormally positioned testis. The exploration may establish the testis’s location and condition; relocation or removal is a distinct therapeutic step when performed.

Report 54550 when the operative service is exploration for an undescended testis, rather than a testicular biopsy, orchiopexy, or orchiectomy. The operative note should identify the indication, approach, findings, and any additional procedure performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For same-session procedures, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. 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 54550 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

54550 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$418.33
Alaska*Unavailable$581.70
ArizonaUnavailable$442.03
ArkansasUnavailable$414.23
AtlantaUnavailable$461.86
AustinUnavailable$456.29
BakersfieldUnavailable$456.44
Baltimore/Surr. CntysUnavailable$474.80
BeaumontUnavailable$436.27
BrazoriaUnavailable$444.63

54550 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
54550 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 54550 rate is calculated

Each of 54550’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 · 54550

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 8.20Practice expense 4.25Malpractice 1.07

13.5200 adjusted RVUs×$33.4009 conversion factor=$451.58

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

Payment rules and modifiers for 54550

54550 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 54550

Testis exploration

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 · 54550

Testis exploration

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

54550 without 50 · national facility

$451.58

Testis exploration

54550-50 · Bilateral: 150%

$677.37

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

54550 compared with similar codes

Compare codes

54550 vs 54560 vs 54640 vs 54500 vs 54505: national Medicare rates

Swap in your local Medicare rate.

  • 54550
    Testis exploration · 8.2 wRVU
    —
  • 54560
    Testicular exploration · 11.8 wRVU
    —
  • 54640
    Orchiopexy · 7.54 wRVU
    —
  • 54500
    Testicular biopsy · 1.28 wRVU
    —
  • 54505
    Testicular biopsy · 3.41 wRVU
    —

How to choose

54560Testicular exploration
54550 is directed at an undescended testis. Use 54560 for a different testicular exploration indication, according to the operative work documented.
54640Orchiopexy
54550 represents exploration to locate and assess an undescended testis; 54640 represents operative fixation of a testis in position.
54500Testicular biopsy
54500 is for needle biopsy to obtain testicular tissue. Choose 54550 when the operation is exploration for an undescended testis.
54505Testicular biopsy
54505 is for incisional testicular biopsy. Exploration for an undescended testis is the distinct purpose of 54550.

Codes related to 54550

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

Codes related to 54550
CodeHow it relatesNational office range
Same family
54560Testicular explorationAnother testicular exploration code; distinguish it by the indication and work documented.No office rate
Used instead
54640OrchiopexyUse for the therapeutic relocation of a testis when orchiopexy is performed.No office rate
54500Testicular biopsyTesticular biopsy by needle when tissue sampling, rather than exploration, is the service.No office rate
54505Testicular biopsyIncisional testicular biopsy when tissue sampling is the operative objective.No office rate
54520Testis removalSimple orchiectomy when the testis is removed rather than explored alone.No office rate

54550 billing questions

When should 54550 be chosen over 54560?

Use 54550 for exploration directed at an undescended testis. Code 54560 describes a different testicular exploration; select based on the documented indication and procedure.

Is orchiopexy separately reported when the testis is found?

If the surgeon fixes the testis in position, report the applicable orchiopexy service for that therapeutic work. Do not automatically report the localization portion as a separate exploration.

What documentation supports 54550?

Document why exploration was needed, the surgical approach, the location and condition of the testis, and whether a separate therapeutic procedure was performed.

How is bilateral exploration reported?

CMS identifies 54550 as a bilateral procedure; reporting modifier 50 results in payment at 150%.

What postoperative care is included?

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

Can an assistant surgeon be paid for this procedure?

CMS permits payment for an assistant at surgery. 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 54550PPRRVU2026_Oct_nonQPP.csv, line 6,315 (RVU26D)

Open CMS sourceHow we calculate rates

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