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Billing code 55040: HydrocelectomyMedicare rate & RVUs

Reports operative removal of one hydrocele, typically for a symptomatic fluid collection around the testicle treated with hydrocelectomy.

CMS RVU26DEffective Oct 1, 2026109 payment localities6.2K Medicare services in 2024

Medicare pays $314.97 for 55040 nationally in a facility.

Medicare rate · 55040

Hydrocelectomy

Swap in your local Medicare rate.

Work RVUs
5.31
Total RVUs
9.43
Global days
090

National rate · 2026

$314.97

Facility setting, before claim adjustments.

See every locality for 55040 → · 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 55040 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 55040 covers

This service is an operation to remove a hydrocele surrounding one testicle. A urologist typically performs it in an operating room for a patient whose scrotal fluid collection causes discomfort, enlargement, or other symptoms. The surgeon exposes the hydrocele sac and removes it as part of the operative treatment; this is different from draining fluid through a needle.

Report 55040 for excision on one side. The operative report should identify the treated side and document the hydrocele and the excision performed. For bilateral excision, use the bilateral code rather than reporting this code with modifier 50. The 90-day global period includes the day-before preoperative visit and related postoperative care during the following 90 days. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Medicare does not pay an assistant at surgery for this code; 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 55040 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

55040 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$290.44
Alaska*Unavailable$400.41
ArizonaUnavailable$308.02
ArkansasUnavailable$287.41
AtlantaUnavailable$322.09
AustinUnavailable$319.23
BakersfieldUnavailable$320.00
Baltimore/Surr. CntysUnavailable$331.74
BeaumontUnavailable$303.04
BrazoriaUnavailable$310.15

55040 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

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
55040 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 55040 rate is calculated

Each of 55040’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 · 55040

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.31Practice expense 3.41Malpractice 0.71

9.4300 adjusted RVUs×$33.4009 conversion factor=$314.97

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

Payment rules and modifiers for 55040

55040 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 55040

Hydrocelectomy

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)0The 150% bilateral adjustment doesn’t apply.
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 · 55040

Hydrocelectomy

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 51 · payment effect

With and without the modifier

55040 without 51 · national facility

$314.97

Hydrocelectomy

55040-51 · Second procedure: 50%

$157.49

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

55040 compared with similar codes

Compare codes

55040 vs 55041 vs 55000 vs 55060: national Medicare rates

Swap in your local Medicare rate.

  • 55040
    Hydrocelectomy · 5.31 wRVU
    —
  • 55041
    Hydrocelectomy · 8.33 wRVU
    —
  • 55000
    Hydrocele drainage · 1.39 wRVU
    $126.26
  • 55060
    Hydrocele repair · 6 wRVU
    —

How to choose

55041Hydrocelectomy
Use 55041 when excision is performed bilaterally. For one-sided excision, report 55040; do not use modifier 50 to represent bilateral treatment.
55000Hydrocele drainage
55000 represents puncture and drainage of a hydrocele. Use 55040 when the surgeon removes the hydrocele operatively.
55060Hydrocele repair
55060 represents repair of a hydrocele, while 55040 is for excision. Select the code that matches the operative service documented.

Codes related to 55040

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

Codes related to 55040
CodeHow it relatesNational office range
Same family
55041HydrocelectomyBilateral hydrocele excision; use for excision on both sides.No office rate
Used instead
55000Hydrocele drainageNeedle drainage rather than operative excision of a hydrocele.$112.93–$161.20
55060Hydrocele repairHydrocele repair rather than excision.No office rate

55040 billing questions

How is 55040 different from 55041?

55040 is for excision of a hydrocele on one side. Use 55041 when hydroceles are excised bilaterally.

Should modifier 50 be added for bilateral excision?

No. Report 55041 for bilateral excision rather than appending modifier 50 to 55040.

When is 55000 reported instead?

55000 describes needle drainage of a hydrocele. Choose 55040 when the surgeon operatively excises the hydrocele rather than draining it.

What postoperative care is included?

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

Can an assistant or co-surgeon be paid for this procedure?

Medicare does not pay an assistant at surgery for 55040. 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 55040PPRRVU2026_Oct_nonQPP.csv, line 6,337 (RVU26D)

Open CMS sourceHow we calculate rates

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