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Billing code 55120: Scrotal lesionMedicare rate & RVUs

Excision of a discrete scrotal lesion is reported when the procedure removes the lesion itself rather than draining an abscess or exploring the scrotum.

CMS RVU26DEffective Oct 1, 2026109 payment localities45 Medicare services in 2024

Medicare pays $331.34 for 55120 nationally in a facility.

Medicare rate · 55120

Scrotal lesion

Swap in your local Medicare rate.

Work RVUs
5.58
Total RVUs
9.92
Global days
090

National rate · 2026

$331.34

Facility setting, before claim adjustments.

See every locality for 55120 → · 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 55120 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 55120 covers

55120 describes surgical removal of a localized lesion from the scrotum. The target is a discrete lesion, such as a scrotal cyst or other abnormal growth; the work is directed at removing that lesion, not draining an abscess or removing scrotal tissue broadly. Urologists and general surgeons perform the procedure, commonly in a facility operating room, when excision is the planned treatment or permits pathologic evaluation.

Report the service when the operative record supports excision of a scrotal lesion, identifying its site and nature, the extent of removal, and any specimen sent for pathology. The code carries a 90-day global period: the day-before preoperative visit and related postoperative care during that period are included. When multiple procedures occur in one session, Medicare pays the highest-valued procedure in full and reduces the others under the standard multiple-procedure rule. Modifier 50 is inappropriate. An assistant is payable only when medical necessity is documented; 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 55120 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

55120 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$305.89
Alaska*Unavailable$421.76
ArizonaUnavailable$324.16
ArkansasUnavailable$302.74
AtlantaUnavailable$338.60
AustinUnavailable$336.04
BakersfieldUnavailable$337.25
Baltimore/Surr. CntysUnavailable$348.79
BeaumontUnavailable$318.74
BrazoriaUnavailable$326.52

55120 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
55120 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 55120 rate is calculated

Each of 55120’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 · 55120

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.58Practice expense 3.63Malpractice 0.71

9.9200 adjusted RVUs×$33.4009 conversion factor=$331.34

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

Payment rules and modifiers for 55120

55120 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 55120

Scrotal lesion

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)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 · 55120

Scrotal lesion

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

55120 without 51 · national facility

$331.34

Scrotal lesion

55120-51 · Second procedure: 50%

$165.67

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

55120 compared with similar codes

Compare codes

55120 vs 55100 vs 55110 vs 55150: national Medicare rates

Swap in your local Medicare rate.

  • 55120
    Scrotal lesion · 5.58 wRVU
    —
  • 55100
    Scrotal abscess drainage · 2.39 wRVU
    $248.17
  • 55110
    Scrotal exploration · 6.17 wRVU
    —
  • 55150
    Scrotectomy · 7.94 wRVU
    —

How to choose

55100Scrotal abscess drainage
Choose 55100 when the procedure drains a scrotal abscess. Choose 55120 when the service removes a discrete scrotal lesion.
55110Scrotal exploration
55110 represents exploration of the scrotum. 55120 is for excision of an identified lesion, not exploration alone.
55150Scrotectomy
55150 involves removal of scrotal tissue more broadly; 55120 targets a localized lesion rather than the scrotum as a whole.

Codes related to 55120

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

Codes related to 55120
CodeHow it relatesNational office range
Used instead
55100Scrotal abscess drainageScrotal abscess drainage treats an abscess rather than excising a discrete lesion.$220.07–$319.86
55110Scrotal explorationScrotal exploration is reported when exploration, rather than lesion excision, is the operative service.No office rate
55150ScrotectomyRemoval of scrotal tissue is a broader procedure than excision of a localized lesion.No office rate

55120 billing questions

How is 55120 different from drainage of a scrotal abscess?

55120 represents removal of a discrete lesion. Drainage of an abscess is a different service directed at evacuating infected contents.

Can modifier 50 be used for lesions on both sides?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.

What care is included in the global period?

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

Can an assistant surgeon be reported?

Assistant-at-surgery payment is available only when the record documents medical necessity. Co-surgeons and team surgery are not permitted.

What documentation supports reporting 55120?

Document the scrotal site, the lesion being removed, the extent of excision, and whether a specimen was sent for pathologic evaluation.

Is the pathology examination part of 55120?

55120 represents the surgeon’s removal of the lesion, not microscopic examination of the specimen. The pathology service is reported separately by the professional performing it when reportable.

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 55120PPRRVU2026_Oct_nonQPP.csv, line 6,342 (RVU26D)

Open CMS sourceHow we calculate rates

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