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CMS RVU26D · Effective 2026-10-01

55870 in Austin

Office / nonfacility

$189.52

Base rate per service

Facility setting

$128.38

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Urology procedure

About 55870: Electroejaculation for semen retrieval

A urologist uses electrical stimulation to induce ejaculation and collect semen, commonly when neurologic injury or dysfunction prevents ejaculation.

A urologist performs electroejaculation by applying controlled electrical stimulation with a rectal probe to induce ejaculation and collect a semen specimen. It is commonly used for fertility evaluation or assisted reproduction when a patient cannot ejaculate voluntarily, including some men with spinal cord injury or other neurologic dysfunction. The procedure may be performed with anesthesia or other support appropriate to the patient and setting.

Report 55870 for the electroejaculation procedure, not for semen analysis or laboratory sperm processing alone. Documentation should identify the reason ejaculation cannot be achieved by usual means, the procedure performed, and the specimen collected. The 0-day global period includes same-day preoperative and postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted; co-surgeons require supporting documentation, and team surgery is not permitted.

CMS billing rules for 55870

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU2.52 · 45%
  • Practice expense (office) RVU2.70 · 49%
  • Malpractice RVU0.33 · 6%

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.

55870 compared with similar codes

Office rates for Austin, from the same CMS release.

89320

Semen anal vol/count/mot

No office rate

55870 is the procedure to induce ejaculation and obtain a specimen; 89320 describes complete laboratory semen analysis.

89321

Semen anal sperm detection

No office rate

Use 89321 for laboratory assessment of sperm presence or motility, not for electrically induced ejaculation and specimen collection.

89264

Identify sperm tissue

No office rate

89264 concerns sperm identification from testicular or epididymal material. 55870 obtains semen by electrically inducing ejaculation.

The same code, a different location

How does Austin compare?

In Beaumont, the office rate for 55870 is $176.48—$13.04 lower than the $189.52 rate in Austin. Both use the same code, release and participation basis.

55870 across payment areas

Same release and payment basis · bars start at $0

  1. Austin · This locality

    $189.52

  2. Beaumont

    $176.48

    $13.04 lower than Austin

  3. Brazoria

    $182.81

    $6.71 lower than Austin

  4. Dallas

    $184.21

    $5.31 lower than Austin

  5. Fort Worth

    $183.45

    $6.07 lower than Austin

  6. Galveston

    $183.52

    $6.00 lower than Austin

  7. Houston

    $189.56

    $0.04 higher than Austin

Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 55870 ranges from $167.31 in Arkansas to $229.38 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Rest Of Texas

    Texas · 55870

    Office

    $179.71

    Facility

    $124.87

    $9.81 lower than Austin for the office setting.

  • Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    California · 55870

    Office

    $201.63

    Facility

    $133.27

    $12.11 higher than Austin for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 55870

    Office

    $207.22

    Facility

    $139.15

    $17.70 higher than Austin for the office setting.

  • Miami

    Florida · 55870

    Office

    $205.93

    Facility

    $145.77

    $16.41 higher than Austin for the office setting.

  • Chicago

    Illinois · 55870

    Office

    $200.69

    Facility

    $142.62

    $11.17 higher than Austin for the office setting.

  • Manhattan

    New York · 55870

    Office

    $211.83

    Facility

    $144.69

    $22.31 higher than Austin for the office setting.

  • Alaska*

    Alaska · 55870

    Office

    $228.37

    Facility

    $166.83

    $38.85 higher than Austin for the office setting.

  • Alabama

    Alabama · 55870

    Office

    $169.32

    Facility

    $118.76

    $20.20 lower than Austin for the office setting.

  • Arkansas

    Arkansas · 55870

    Office

    $167.31

    Facility

    $117.68

    $22.21 lower than Austin for the office setting.

  • Arizona

    Arizona · 55870

    Office

    $180.99

    Facility

    $125.00

    $8.53 lower than Austin for the office setting.

  • Bakersfield

    California · 55870

    Office

    $191.32

    Facility

    $127.99

    $1.80 higher than Austin for the office setting.

  • Chico

    California · 55870

    Office

    $190.35

    Facility

    $127.02

    $0.83 higher than Austin for the office setting.

  • El Centro

    California · 55870

    Office

    $190.40

    Facility

    $127.07

    $0.88 higher than Austin for the office setting.

  • Fresno

    California · 55870

    Office

    $190.35

    Facility

    $127.02

    $0.83 higher than Austin for the office setting.

  • Hanford-Corcoran

    California · 55870

    Office

    $190.35

    Facility

    $127.02

    $0.83 higher than Austin for the office setting.

  • Madera

    California · 55870

    Office

    $190.35

    Facility

    $127.02

    $0.83 higher than Austin for the office setting.

  • Merced

    California · 55870

    Office

    $190.35

    Facility

    $127.02

    $0.83 higher than Austin for the office setting.

  • Modesto

    California · 55870

    Office

    $190.35

    Facility

    $127.02

    $0.83 higher than Austin for the office setting.

  • Napa

    California · 55870

    Office

    $213.93

    Facility

    $137.77

    $24.41 higher than Austin for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 55870

    Office

    $199.99

    Facility

    $131.69

    $10.47 higher than Austin for the office setting.

  • Redding

    California · 55870

    Office

    $190.35

    Facility

    $127.02

    $0.83 higher than Austin for the office setting.

  • Rest Of California

    California · 55870

    Office

    $190.35

    Facility

    $127.02

    $0.83 higher than Austin for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 55870

    Office

    $193.93

    Facility

    $130.60

    $4.41 higher than Austin for the office setting.

  • Sacramento-Roseville-Folsom

    California · 55870

    Office

    $197.99

    Facility

    $130.79

    $8.47 higher than Austin for the office setting.

  • Salinas

    California · 55870

    Office

    $197.21

    Facility

    $130.24

    $7.69 higher than Austin for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 55870

    Office

    $200.53

    Facility

    $131.42

    $11.01 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 55870

    Office

    $224.38

    Facility

    $142.91

    $34.86 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 55870

    Office

    $224.01

    Facility

    $142.53

    $34.49 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 55870

    Office

    $229.38

    Facility

    $146.06

    $39.86 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 55870

    Office

    $227.85

    Facility

    $144.52

    $38.33 higher than Austin for the office setting.

  • San Luis Obispo-Paso Robles

    California · 55870

    Office

    $194.23

    Facility

    $128.41

    $4.71 higher than Austin for the office setting.

  • Santa Cruz-Watsonville

    California · 55870

    Office

    $201.42

    Facility

    $131.21

    $11.90 higher than Austin for the office setting.

  • Santa Maria-Santa Barbara

    California · 55870

    Office

    $197.59

    Facility

    $130.21

    $8.07 higher than Austin for the office setting.

  • Santa Rosa-Petaluma

    California · 55870

    Office

    $203.35

    Facility

    $132.39

    $13.83 higher than Austin for the office setting.

  • Stockton

    California · 55870

    Office

    $190.35

    Facility

    $127.02

    $0.83 higher than Austin for the office setting.

  • Vallejo

    California · 55870

    Office

    $213.39

    Facility

    $137.23

    $23.87 higher than Austin for the office setting.

  • Visalia

    California · 55870

    Office

    $190.35

    Facility

    $127.02

    $0.83 higher than Austin for the office setting.

  • Yuba City

    California · 55870

    Office

    $190.35

    Facility

    $127.02

    $0.83 higher than Austin for the office setting.

  • Colorado

    Colorado · 55870

    Office

    $189.74

    Facility

    $128.26

    $0.22 higher than Austin for the office setting.

  • Connecticut

    Connecticut · 55870

    Office

    $196.32

    Facility

    $134.08

    $6.80 higher than Austin for the office setting.

  • Delaware

    Delaware · 55870

    Office

    $183.60

    Facility

    $126.51

    $5.92 lower than Austin for the office setting.

  • Fort Lauderdale

    Florida · 55870

    Office

    $195.45

    Facility

    $136.92

    $5.93 higher than Austin for the office setting.

  • Rest Of Florida

    Florida · 55870

    Office

    $186.95

    Facility

    $131.71

    $2.57 lower than Austin for the office setting.

  • Atlanta

    Georgia · 55870

    Office

    $189.29

    Facility

    $130.58

    $0.23 lower than Austin for the office setting.

  • Rest Of Georgia

    Georgia · 55870

    Office

    $177.75

    Facility

    $126.21

    $11.77 lower than Austin for the office setting.

  • Hawaii, Guam

    Hawaii · 55870

    Office

    $193.09

    Facility

    $127.39

    $3.57 higher than Austin for the office setting.

  • Iowa

    Iowa · 55870

    Office

    $171.06

    Facility

    $118.19

    $18.46 lower than Austin for the office setting.

  • Idaho

    Idaho · 55870

    Office

    $172.35

    Facility

    $119.19

    $17.17 lower than Austin for the office setting.

  • East St. Louis

    Illinois · 55870

    Office

    $189.34

    Facility

    $136.18

    $0.18 lower than Austin for the office setting.

  • Rest Of Illinois

    Illinois · 55870

    Office

    $183.73

    Facility

    $130.98

    $5.79 lower than Austin for the office setting.

  • Suburban Chicago

    Illinois · 55870

    Office

    $196.91

    Facility

    $137.56

    $7.39 higher than Austin for the office setting.

  • Indiana

    Indiana · 55870

    Office

    $173.13

    Facility

    $119.56

    $16.39 lower than Austin for the office setting.

  • Kansas

    Kansas · 55870

    Office

    $171.25

    Facility

    $119.01

    $18.27 lower than Austin for the office setting.

  • Kentucky

    Kentucky · 55870

    Office

    $174.43

    Facility

    $123.06

    $15.09 lower than Austin for the office setting.

  • New Orleans

    Louisiana · 55870

    Office

    $181.55

    Facility

    $127.18

    $7.97 lower than Austin for the office setting.

  • Rest Of Louisiana

    Louisiana · 55870

    Office

    $174.54

    Facility

    $123.40

    $14.98 lower than Austin for the office setting.

  • Metropolitan Boston

    Massachusetts · 55870

    Office

    $205.11

    Facility

    $136.12

    $15.59 higher than Austin for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 55870

    Office

    $189.26

    Facility

    $128.42

    $0.26 lower than Austin for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 55870

    Office

    $195.92

    Facility

    $133.92

    $6.40 higher than Austin for the office setting.

  • Rest Of Maryland

    Maryland · 55870

    Office

    $186.40

    Facility

    $127.92

    $3.12 lower than Austin for the office setting.

  • Rest Of Maine

    Maine · 55870

    Office

    $173.99

    Facility

    $120.83

    $15.53 lower than Austin for the office setting.

  • Southern Maine

    Maine · 55870

    Office

    $180.50

    Facility

    $123.23

    $9.02 lower than Austin for the office setting.

  • Detroit

    Michigan · 55870

    Office

    $189.78

    Facility

    $134.02

    $0.26 higher than Austin for the office setting.

  • Rest Of Michigan

    Michigan · 55870

    Office

    $178.95

    Facility

    $126.19

    $10.57 lower than Austin for the office setting.

  • Minnesota

    Minnesota · 55870

    Office

    $180.23

    Facility

    $120.77

    $9.29 lower than Austin for the office setting.

  • Metropolitan Kansas City

    Missouri · 55870

    Office

    $179.62

    Facility

    $125.36

    $9.90 lower than Austin for the office setting.

  • Metropolitan St. Louis

    Missouri · 55870

    Office

    $181.07

    Facility

    $126.06

    $8.45 lower than Austin for the office setting.

  • Rest Of Missouri

    Missouri · 55870

    Office

    $172.64

    Facility

    $122.83

    $16.88 lower than Austin for the office setting.

  • Mississippi

    Mississippi · 55870

    Office

    $169.96

    Facility

    $120.21

    $19.56 lower than Austin for the office setting.

  • Montana**

    Montana · 55870

    Office

    $185.35

    Facility

    $127.57

    $4.17 lower than Austin for the office setting.

  • North Carolina

    North Carolina · 55870

    Office

    $175.35

    Facility

    $121.44

    $14.17 lower than Austin for the office setting.

  • North Dakota**

    North Dakota · 55870

    Office

    $178.83

    Facility

    $121.04

    $10.69 lower than Austin for the office setting.

  • Nebraska

    Nebraska · 55870

    Office

    $171.58

    Facility

    $118.24

    $17.94 lower than Austin for the office setting.

  • New Hampshire

    New Hampshire · 55870

    Office

    $187.69

    Facility

    $127.54

    $1.83 lower than Austin for the office setting.

  • Northern Nj

    New Jersey · 55870

    Office

    $205.86

    Facility

    $138.83

    $16.34 higher than Austin for the office setting.

  • Rest Of New Jersey

    New Jersey · 55870

    Office

    $198.11

    Facility

    $135.01

    $8.59 higher than Austin for the office setting.

  • New Mexico

    New Mexico · 55870

    Office

    $180.11

    Facility

    $127.12

    $9.41 lower than Austin for the office setting.

  • Nevada**

    Nevada · 55870

    Office

    $183.62

    Facility

    $125.78

    $5.90 lower than Austin for the office setting.

  • Nyc Suburbs/Long Island

    New York · 55870

    Office

    $217.25

    Facility

    $148.55

    $27.73 higher than Austin for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 55870

    Office

    $200.04

    Facility

    $136.77

    $10.52 higher than Austin for the office setting.

  • Queens

    New York · 55870

    Office

    $212.05

    Facility

    $143.75

    $22.53 higher than Austin for the office setting.

  • Rest Of New York

    New York · 55870

    Office

    $177.59

    Facility

    $122.70

    $11.93 lower than Austin for the office setting.

  • Ohio

    Ohio · 55870

    Office

    $177.62

    Facility

    $124.86

    $11.90 lower than Austin for the office setting.

  • Oklahoma

    Oklahoma · 55870

    Office

    $173.27

    Facility

    $121.67

    $16.25 lower than Austin for the office setting.

  • Portland

    Oregon · 55870

    Office

    $193.91

    Facility

    $129.71

    $4.39 higher than Austin for the office setting.

  • Rest Of Oregon

    Oregon · 55870

    Office

    $181.74

    Facility

    $124.19

    $7.78 lower than Austin for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 55870

    Office

    $192.71

    Facility

    $132.56

    $3.19 higher than Austin for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 55870

    Office

    $177.37

    Facility

    $124.33

    $12.15 lower than Austin for the office setting.

  • Puerto Rico

    Puerto Rico · 55870

    Office

    $186.20

    Facility

    $127.78

    $3.32 lower than Austin for the office setting.

  • Rhode Island

    Rhode Island · 55870

    Office

    $188.76

    Facility

    $129.07

    $0.76 lower than Austin for the office setting.

  • South Carolina

    South Carolina · 55870

    Office

    $176.87

    Facility

    $123.48

    $12.65 lower than Austin for the office setting.

  • South Dakota**

    South Dakota · 55870

    Office

    $178.06

    Facility

    $120.27

    $11.46 lower than Austin for the office setting.

  • Tennessee

    Tennessee · 55870

    Office

    $172.07

    Facility

    $119.54

    $17.45 lower than Austin for the office setting.

  • Utah

    Utah · 55870

    Office

    $178.84

    Facility

    $124.52

    $10.68 lower than Austin for the office setting.

  • Virginia

    Virginia · 55870

    Office

    $180.60

    Facility

    $123.80

    $8.92 lower than Austin for the office setting.

  • Virgin Islands

    United States Virgin Islands · 55870

    Office

    $186.20

    Facility

    $127.78

    $3.32 lower than Austin for the office setting.

  • Vermont

    Vermont · 55870

    Office

    $179.03

    Facility

    $121.82

    $10.49 lower than Austin for the office setting.

  • Rest Of Washington

    Washington · 55870

    Office

    $188.61

    Facility

    $127.77

    $0.91 lower than Austin for the office setting.

  • Seattle (King Cnty)

    Washington · 55870

    Office

    $208.04

    Facility

    $137.14

    $18.52 higher than Austin for the office setting.

  • Wisconsin

    Wisconsin · 55870

    Office

    $173.96

    Facility

    $118.60

    $15.56 lower than Austin for the office setting.

  • West Virginia

    West Virginia · 55870

    Office

    $178.31

    Facility

    $128.10

    $11.21 lower than Austin for the office setting.

  • Wyoming**

    Wyoming · 55870

    Office

    $182.51

    Facility

    $124.73

    $7.01 lower than Austin for the office setting.

See how rates vary across the country

55870 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$167.31

$228.37

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$228.371
AL$169.321
AR$167.311
AZ$180.991
CA$190.35–$229.3829
CO$189.741
CT$196.321
DC$207.221
DE$183.601
FL$186.95–$205.933
GA$177.75–$189.292
GU$193.091
HI$193.091
IA$171.061
ID$172.351
IL$183.73–$200.694
IN$173.131
KS$171.251
KY$174.431
LA$174.54–$181.552
MA$189.26–$205.112
MD$186.40–$207.223
ME$173.99–$180.502
MI$178.95–$189.782
MN$180.231
MO$172.64–$181.073
MS$169.961
MT$185.351
NC$175.351
ND$178.831
NE$171.581
NH$187.691
NJ$198.11–$205.862
NM$180.111
NV$183.621
NY$177.59–$217.255
OH$177.621
OK$173.271
OR$181.74–$193.912
PA$177.37–$192.712
PR$186.201
RI$188.761
SC$176.871
SD$178.061
TN$172.071
TX$176.48–$189.568
UT$178.841
VA$180.60–$207.222
VI$186.201
VT$179.031
WA$188.61–$208.042
WI$173.961
WV$178.311
WY$182.511

Explore 55870 on the national rate map →

Where does this rate apply?

Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Texas →

Why are the office and facility amounts different?

For 55870 in Austin, the physician’s office rate is $189.52 and the facility-setting rate is $128.38: a difference of $61.14.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 55870 in Austin. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$208.47

$189.52 × 110% = $208.47

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 55870 in Austin.

PPRRVU2026_Oct_nonQPP.csv

6,390

Code
55870
Physician work
2.52
Practice expense
2.70
Malpractice
0.33

GPCI2026.csv

96

Locality
Austin
Physician work
1.002
Practice expense
1.058
Malpractice
0.886
Office / nonfacility calculation for 55870 in Austin
ComponentRVULocality factorAdjusted
Physician work2.52× 1.0022.5250
Practice expense2.70× 1.0582.8566
Malpractice0.33× 0.8860.2924
Total RVUs5.6740
Conversion factor× 33.4009

Office / nonfacility rate, Austin$189.52

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 55870 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work2.521.002
Practice expense2.71.058
Malpractice0.330.886

(2.52 × 1.002 + 2.7 × 1.058 + 0.33 × 0.886) × $33.4009 = $189.52

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work2.521.002
Practice expense0.971.058
Malpractice0.330.886

(2.52 × 1.002 + 0.97 × 1.058 + 0.33 × 0.886) × $33.4009 = $128.38

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

55870 · Office / nonfacility

$189.52

Effective 2026-10-01

The base rate is $11.93 higher than on 2025-10-01, moving from $177.59 to $189.52 (6.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $177.59changed to$189.52

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.58 changed to 2.52
    • Practice expense RVU 2.52 changed to 2.70
    • Malpractice RVU 0.30 changed to 0.33
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.046 changed to 1.058
    • Malpractice GPCI 0.914 changed to 0.886

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $177.59

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$189.52$128.38RVU26D
2026-07-01$189.52$128.38RVU26C
2026-04-01$189.52$128.38RVU26B
2026-01-01$189.52$128.38RVU26A
2025-10-01$177.59$138.00RVU25D
2025-07-01$177.59$138.00RVU25C
2025-04-01$177.59$138.00RVU25B
2025-01-01$177.59$138.00RVU25A

55870 billing questions

When is 55870 appropriate instead of a semen analysis code?

Use 55870 for the procedure that electrically induces ejaculation and collects semen. A semen analysis code describes laboratory examination of a specimen, not the retrieval procedure.

Can semen analysis or sperm processing be reported separately?

A laboratory service such as semen analysis or sperm isolation is distinct from electroejaculation when it is actually performed and documented. Report the applicable laboratory service rather than treating it as part of the retrieval procedure.

Does modifier 50 apply if stimulation is performed bilaterally?

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

What same-day care is included in the global period?

The 0-day global period includes same-day preoperative and postoperative care. It does not extend the global period beyond the day of the procedure.

How is 55870 affected when another procedure is performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are subject to the reduction. Assistant-at-surgery payment is restricted, co-surgeons require supporting documentation, and team surgery is 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 55870PPRRVU2026_Oct_nonQPP.csv, line 6,390 (RVU26D)
Geographic factors for AustinGPCI2026.csv, line 96 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet