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CPT 54650: OrchiopexyMedicare rate & RVUs

Reports surgical placement of an undescended abdominal testis using a Fowler-Stephens technique, typically when a high testis cannot reach the scrotum safely.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $647.98 for 54650 nationally in a facility.

Medicare rate · 54650

Orchiopexy

Swap in your local Medicare rate.

Work RVUs
12.08
Total RVUs
19.40
Global days
090

National rate · 2026

$647.98

Facility setting, before claim adjustments.

See every locality for 54650 →

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 54650 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 54650 covers

This operation treats a testis that remains within the abdomen and cannot be brought to the scrotum without addressing its blood supply. In the Fowler-Stephens technique, the surgeon divides the testicular vessels so collateral circulation can support the testis as it is moved into the scrotum. Pediatric urologists commonly perform the procedure for a high intra-abdominal undescended testis; it may be completed in stages depending on the operative plan and anatomy.

Report the code when the operative documentation supports Fowler-Stephens orchiopexy for an abdominal testis, including the side treated and whether the procedure was staged. The CMS global period includes the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery, modifier 50 is paid at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. 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 54650 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

54650 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$601.52
Alaska*Unavailable$839.17
ArizonaUnavailable$634.59
ArkansasUnavailable$595.81
AtlantaUnavailable$662.62
AustinUnavailable$654.12
BakersfieldUnavailable$654.07
Baltimore/Surr. CntysUnavailable$680.72
BeaumontUnavailable$626.95
BrazoriaUnavailable$638.15

54650 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
54650 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 54650 rate is calculated

Each of 54650’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 · 54650

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 12.08Practice expense 5.78Malpractice 1.54

19.4000 adjusted RVUs×$33.4009 conversion factor=$647.98

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

Payment rules and modifiers for 54650

54650 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 54650

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)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 · 54650

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

54650 without 50 · national facility

$647.98

Orchiopexy

54650-50 · Bilateral: 150%

$971.97

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

54650 compared with similar codes

Compare codes

54650 vs 54640 vs 54692 vs 54620: national Medicare rates

Swap in your local Medicare rate.

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

How to choose

54640Orchiopexy
54640 is for orchiopexy through an inguinal or scrotal approach. Select 54650 when the operative report documents Fowler-Stephens treatment of an abdominal testis.
54692Laparoscopic orchiopexy
54692 identifies laparoscopic orchiopexy. Distinguish it from 54650 by the documented procedure and approach, not simply by the testis being undescended.
54620Testicular suspension
54620 describes testicular fixation, commonly in a different clinical context. It is not the code for Fowler-Stephens placement of an abdominal undescended testis.

Codes related to 54650

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

Codes related to 54650
CodeHow it relatesNational office range
Same family
54640OrchiopexyOrchiopexy by an inguinal or scrotal approach rather than Fowler-Stephens treatment of an abdominal testis.No office rate
Used instead
54692Laparoscopic orchiopexyLaparoscopic orchiopexy, a distinct approach for surgical fixation of an undescended testis.No office rate
54620Testicular suspensionTesticular fixation for a different indication, rather than Fowler-Stephens repair of an abdominal undescended testis.No office rate

54650 billing questions

When should this code be selected instead of 54640?

Use 54650 for Fowler-Stephens orchiopexy of an abdominal testis. Code 54640 describes orchiopexy by an inguinal or scrotal approach.

How does this differ from laparoscopic orchiopexy code 54692?

Code 54692 identifies laparoscopic orchiopexy. Choose the code that matches the documented procedure and approach; an abdominal testis alone does not establish that the Fowler-Stephens code applies.

What operative details support reporting 54650?

Document the abdominal location of the undescended testis, the Fowler-Stephens technique, the side treated, and whether the repair was staged.

How is bilateral surgery reported?

For bilateral surgery, report modifier 50; CMS pays the bilateral procedure at 150%.

Can an assistant surgeon be reported?

CMS permits payment for an assistant at surgery. Co-surgeons and team surgery are not permitted for this code.

What postoperative care is included?

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

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 54650PPRRVU2026_Oct_nonQPP.csv, line 6,320 (RVU26D)

Open CMS sourceHow we calculate rates

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