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Billing code 54640: OrchiopexyMedicare rate & RVUs

Reports open repositioning and fixation of an undescended testis through an inguinal or scrotal approach, commonly performed for cryptorchidism.

CMS RVU26DEffective Oct 1, 2026109 payment localities224 Medicare services in 2024

Medicare pays $393.80 for 54640 nationally in a facility.

Medicare rate · 54640

Orchiopexy

Swap in your local Medicare rate.

Work RVUs
7.54
Total RVUs
11.79
Global days
090

National rate · 2026

$393.80

Facility setting, before claim adjustments.

See every locality for 54640 → · 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 54640 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 54640 covers

A urologist, often a pediatric urologist, uses an inguinal or scrotal approach to mobilize an undescended testis and secure it in the scrotum. The operation is commonly performed for cryptorchidism in a hospital or ambulatory surgery setting. The operative report should identify the testis location, approach, side, and the work performed to bring the testis into the scrotum and fix it there.

Report this code for the inguinal or scrotal approach; an abdominal or laparoscopic approach has a different code. For bilateral surgery, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. Assistant-at-surgery payment requires documentation of medical necessity; 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 54640 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

54640 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$365.22
Alaska*Unavailable$510.92
ArizonaUnavailable$385.43
ArkansasUnavailable$361.72
AtlantaUnavailable$403.31
AustinUnavailable$396.50
BakersfieldUnavailable$395.13
Baltimore/Surr. CntysUnavailable$413.94
BeaumontUnavailable$381.69
BrazoriaUnavailable$387.13

54640 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
54640 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 54640 rate is calculated

Each of 54640’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 · 54640

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 7.54Practice expense 3.20Malpractice 1.05

11.7900 adjusted RVUs×$33.4009 conversion factor=$393.80

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

Payment rules and modifiers for 54640

54640 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 54640

Orchiopexy

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)0Not paid without supporting documentation.
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 · 54640

Orchiopexy

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

54640 without 50 · national facility

$393.80

Orchiopexy

54640-50 · Bilateral: 150%

$590.70

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

54640 compared with similar codes

Compare codes

54640 vs 54650 vs 54692 vs 54620: national Medicare rates

Swap in your local Medicare rate.

  • 54640
    Orchiopexy · 7.54 wRVU
    —
  • 54650
    Orchiopexy · 12.08 wRVU
    —
  • 54692
    Laparoscopic orchiopexy · 13.4 wRVU
    —
  • 54620
    Testicular suspension · 5.08 wRVU
    —

How to choose

54650Orchiopexy
Choose 54640 for an inguinal or scrotal approach. Choose 54650 when an abdominal approach is used, including for a Fowler-Stephens procedure.
54692Laparoscopic orchiopexy
54692 identifies laparoscopic orchiopexy; 54640 identifies an inguinal or scrotal approach.
54620Testicular suspension
54620 is fixation of a non-cryptorchid testis. 54640 is for bringing an undescended testis into the scrotum and fixing it there.

Codes related to 54640

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

Codes related to 54640
CodeHow it relatesNational office range
Same family
54650OrchiopexyOrchiopexy by abdominal approach, including the Fowler-Stephens method.No office rate
Used instead
54692Laparoscopic orchiopexyLaparoscopic approach for orchiopexy rather than the inguinal or scrotal approach.No office rate
54620Testicular suspensionFixation for a non-cryptorchid testis, rather than surgical descent of an undescended testis.No office rate

54640 billing questions

When should 54640 be selected instead of 54650?

Use 54640 for an inguinal or scrotal approach to an undescended testis. Code 54650 describes an abdominal approach, including the Fowler-Stephens method.

How does 54640 differ from laparoscopic orchiopexy?

54640 is for an inguinal or scrotal approach. Laparoscopic orchiopexy is reported with 54692.

How is bilateral orchiopexy reported under the CMS rule?

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

What documentation supports reporting 54640?

The operative report should establish that the testis was undescended and document its location, the inguinal or scrotal approach, the side or sides treated, and the repositioning and fixation performed.

Does the 90-day global period include postoperative care?

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

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted under the listed CMS rules.

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 54640PPRRVU2026_Oct_nonQPP.csv, line 6,319 (RVU26D)

Open CMS sourceHow we calculate rates

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