No office rate
54500 describes needle biopsy of the testis. Use 54560 when the surgeon performs operative exploration, with or without biopsy.
On this page
CMS RVU26D · Effective 2026-10-01
54560 in Delaware
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$618.02
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 surgery
About 54560: Surgical testicular exploration
Reports operative inspection of a testis to investigate a suspected abnormality, whether or not the surgeon takes a biopsy during the exploration.
A urologist surgically exposes and examines a testis when evaluation requires direct inspection of the organ. The surgeon may take a biopsy during the exploration. This is an operative service, generally performed in a surgical setting; it is distinct from obtaining a testicular biopsy alone or exploring for an undescended testis.
Report 54560 when the operative work is exploration of the testis, with or without biopsy. The operative note should identify the side, the reason for exploration, the findings, and whether a biopsy was obtained. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related 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. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be allowed; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 54560
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU11.80 · 63%
- Practice expense (office) RVU5.36 · 29%
- Malpractice RVU1.50 · 8%
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.
54560 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
54505 describes an incisional testicular biopsy. Choose 54560 when the service is testicular exploration rather than biopsy alone.
No office rate
54550 is for exploration of an undescended testis. 54560 is used for exploration of a testis for another suspected abnormality.
No office rate
54512 is for excision of a testicular lesion. Use 54560 when the operative service is exploration, not removal of a lesion.
The same code, a different location
How does Delaware compare?
54560 across payment areas
Same release and payment basis · bars start at $0
Delaware · This locality
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Delaware appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
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
Alabama
Alabama · 54560
Office
Unavailable
Facility
$579.14
No comparable office rate is available.
Arkansas
Arkansas · 54560
Office
Unavailable
Facility
$573.72
No comparable office rate is available.
Arizona
Arizona · 54560
Office
Unavailable
Facility
$610.50
No comparable office rate is available.
Bakersfield
California · 54560
Office
Unavailable
Facility
$628.35
No comparable office rate is available.
Chico
California · 54560
Office
Unavailable
Facility
$623.90
No comparable office rate is available.
El Centro
California · 54560
Office
Unavailable
Facility
$624.15
No comparable office rate is available.
Fresno
California · 54560
Office
Unavailable
Facility
$623.90
No comparable office rate is available.
Hanford-Corcoran
California · 54560
Office
Unavailable
Facility
$623.90
No comparable office rate is available.
Madera
California · 54560
Office
Unavailable
Facility
$623.90
No comparable office rate is available.
Merced
California · 54560
Office
Unavailable
Facility
$623.90
No comparable office rate is available.
Modesto
California · 54560
Office
Unavailable
Facility
$623.90
No comparable office rate is available.
Napa
California · 54560
Office
Unavailable
Facility
$680.37
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 54560
Office
Unavailable
Facility
$647.99
No comparable office rate is available.
Redding
California · 54560
Office
Unavailable
Facility
$623.90
No comparable office rate is available.
Rest Of California
California · 54560
Office
Unavailable
Facility
$623.90
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 54560
Office
Unavailable
Facility
$640.18
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 54560
Office
Unavailable
Facility
$643.38
No comparable office rate is available.
Salinas
California · 54560
Office
Unavailable
Facility
$640.70
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 54560
Office
Unavailable
Facility
$647.23
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 54560
Office
Unavailable
Facility
$707.00
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 54560
Office
Unavailable
Facility
$705.30
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 54560
Office
Unavailable
Facility
$722.50
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 54560
Office
Unavailable
Facility
$715.53
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 54560
Office
Unavailable
Facility
$631.60
No comparable office rate is available.
Santa Cruz-Watsonville
California · 54560
Office
Unavailable
Facility
$646.78
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 54560
Office
Unavailable
Facility
$640.77
No comparable office rate is available.
Santa Rosa-Petaluma
California · 54560
Office
Unavailable
Facility
$652.66
No comparable office rate is available.
Stockton
California · 54560
Office
Unavailable
Facility
$623.90
No comparable office rate is available.
Vallejo
California · 54560
Office
Unavailable
Facility
$677.92
No comparable office rate is available.
Visalia
California · 54560
Office
Unavailable
Facility
$623.90
No comparable office rate is available.
Yuba City
California · 54560
Office
Unavailable
Facility
$623.90
No comparable office rate is available.
Colorado
Colorado · 54560
Office
Unavailable
Facility
$628.48
No comparable office rate is available.
Connecticut
Connecticut · 54560
Office
Unavailable
Facility
$655.45
No comparable office rate is available.
Fort Lauderdale
Florida · 54560
Office
Unavailable
Facility
$666.07
No comparable office rate is available.
Rest Of Florida
Florida · 54560
Office
Unavailable
Facility
$640.58
No comparable office rate is available.
Atlanta
Georgia · 54560
Office
Unavailable
Facility
$637.38
No comparable office rate is available.
Rest Of Georgia
Georgia · 54560
Office
Unavailable
Facility
$613.55
No comparable office rate is available.
Hawaii, Guam
Hawaii · 54560
Office
Unavailable
Facility
$626.70
No comparable office rate is available.
Iowa
Iowa · 54560
Office
Unavailable
Facility
$577.83
No comparable office rate is available.
Idaho
Idaho · 54560
Office
Unavailable
Facility
$582.54
No comparable office rate is available.
East St. Louis
Illinois · 54560
Office
Unavailable
Facility
$659.74
No comparable office rate is available.
Rest Of Illinois
Illinois · 54560
Office
Unavailable
Facility
$635.89
No comparable office rate is available.
Suburban Chicago
Illinois · 54560
Office
Unavailable
Facility
$669.53
No comparable office rate is available.
Indiana
Indiana · 54560
Office
Unavailable
Facility
$584.44
No comparable office rate is available.
Kansas
Kansas · 54560
Office
Unavailable
Facility
$581.22
No comparable office rate is available.
Kentucky
Kentucky · 54560
Office
Unavailable
Facility
$599.13
No comparable office rate is available.
New Orleans
Louisiana · 54560
Office
Unavailable
Facility
$619.51
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 54560
Office
Unavailable
Facility
$600.57
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 54560
Office
Unavailable
Facility
$668.64
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 54560
Office
Unavailable
Facility
$628.88
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 54560
Office
Unavailable
Facility
$654.51
No comparable office rate is available.
Rest Of Maryland
Maryland · 54560
Office
Unavailable
Facility
$625.24
No comparable office rate is available.
Rest Of Maine
Maine · 54560
Office
Unavailable
Facility
$590.00
No comparable office rate is available.
Southern Maine
Maine · 54560
Office
Unavailable
Facility
$603.16
No comparable office rate is available.
Detroit
Michigan · 54560
Office
Unavailable
Facility
$651.36
No comparable office rate is available.
Rest Of Michigan
Michigan · 54560
Office
Unavailable
Facility
$614.15
No comparable office rate is available.
Minnesota
Minnesota · 54560
Office
Unavailable
Facility
$593.18
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 54560
Office
Unavailable
Facility
$611.19
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 54560
Office
Unavailable
Facility
$614.77
No comparable office rate is available.
Rest Of Missouri
Missouri · 54560
Office
Unavailable
Facility
$597.25
No comparable office rate is available.
Mississippi
Mississippi · 54560
Office
Unavailable
Facility
$585.30
No comparable office rate is available.
Montana**
Montana · 54560
Office
Unavailable
Facility
$623.16
No comparable office rate is available.
North Carolina
North Carolina · 54560
Office
Unavailable
Facility
$593.18
No comparable office rate is available.
North Dakota**
North Dakota · 54560
Office
Unavailable
Facility
$593.50
No comparable office rate is available.
Nebraska
Nebraska · 54560
Office
Unavailable
Facility
$578.31
No comparable office rate is available.
New Hampshire
New Hampshire · 54560
Office
Unavailable
Facility
$624.34
No comparable office rate is available.
Northern Nj
New Jersey · 54560
Office
Unavailable
Facility
$680.14
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 54560
Office
Unavailable
Facility
$660.36
No comparable office rate is available.
New Mexico
New Mexico · 54560
Office
Unavailable
Facility
$618.47
No comparable office rate is available.
Nevada**
Nevada · 54560
Office
Unavailable
Facility
$615.07
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 54560
Office
Unavailable
Facility
$725.26
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 54560
Office
Unavailable
Facility
$668.53
No comparable office rate is available.
Queens
New York · 54560
Office
Unavailable
Facility
$703.21
No comparable office rate is available.
Rest Of New York
New York · 54560
Office
Unavailable
Facility
$599.43
No comparable office rate is available.
Ohio
Ohio · 54560
Office
Unavailable
Facility
$608.09
No comparable office rate is available.
Oklahoma
Oklahoma · 54560
Office
Unavailable
Facility
$592.93
No comparable office rate is available.
Portland
Oregon · 54560
Office
Unavailable
Facility
$636.61
No comparable office rate is available.
Rest Of Oregon
Oregon · 54560
Office
Unavailable
Facility
$607.66
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 54560
Office
Unavailable
Facility
$647.36
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 54560
Office
Unavailable
Facility
$605.82
No comparable office rate is available.
Puerto Rico
Puerto Rico · 54560
Office
Unavailable
Facility
$624.48
No comparable office rate is available.
Rhode Island
Rhode Island · 54560
Office
Unavailable
Facility
$631.25
No comparable office rate is available.
South Carolina
South Carolina · 54560
Office
Unavailable
Facility
$602.14
No comparable office rate is available.
South Dakota**
South Dakota · 54560
Office
Unavailable
Facility
$589.99
No comparable office rate is available.
Tennessee
Tennessee · 54560
Office
Unavailable
Facility
$583.77
No comparable office rate is available.
Austin
Texas · 54560
Office
Unavailable
Facility
$628.72
No comparable office rate is available.
Beaumont
Texas · 54560
Office
Unavailable
Facility
$603.59
No comparable office rate is available.
Brazoria
Texas · 54560
Office
Unavailable
Facility
$613.78
No comparable office rate is available.
Dallas
Texas · 54560
Office
Unavailable
Facility
$618.98
No comparable office rate is available.
Fort Worth
Texas · 54560
Office
Unavailable
Facility
$617.84
No comparable office rate is available.
Galveston
Texas · 54560
Office
Unavailable
Facility
$616.54
No comparable office rate is available.
Houston
Texas · 54560
Office
Unavailable
Facility
$644.00
No comparable office rate is available.
Rest Of Texas
Texas · 54560
Office
Unavailable
Facility
$609.27
No comparable office rate is available.
Utah
Utah · 54560
Office
Unavailable
Facility
$607.41
No comparable office rate is available.
Virginia
Virginia · 54560
Office
Unavailable
Facility
$605.49
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 54560
Office
Unavailable
Facility
$624.48
No comparable office rate is available.
Vermont
Vermont · 54560
Office
Unavailable
Facility
$596.72
No comparable office rate is available.
Rest Of Washington
Washington · 54560
Office
Unavailable
Facility
$625.90
No comparable office rate is available.
Seattle (King Cnty)
Washington · 54560
Office
Unavailable
Facility
$674.44
No comparable office rate is available.
Wisconsin
Wisconsin · 54560
Office
Unavailable
Facility
$581.07
No comparable office rate is available.
West Virginia
West Virginia · 54560
Office
Unavailable
Facility
$621.40
No comparable office rate is available.
Wyoming**
Wyoming · 54560
Office
Unavailable
Facility
$610.23
No comparable office rate is available.
See how rates vary across the country
54560 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, 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.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 54560 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$679.82
$618.02 × 110% = $679.82
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.
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 54560 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
6,316
- Code
- 54560
- Physician work
- 11.80
- Practice expense
- 5.36
- Malpractice
- 1.50
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.80 | × 1.005 | 11.8590 |
| Practice expense | 5.36 | × 0.988 | 5.2957 |
| Malpractice | 1.50 | × 0.899 | 1.3485 |
| Total RVUs | 18.5032 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$618.02
Open 54560 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.8 | 1.005 |
| Practice expense | 5.36 | 0.988 |
| Malpractice | 1.5 | 0.899 |
(11.8 × 1.005 + 5.36 × 0.988 + 1.5 × 0.899) × $33.4009 = $618.02
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
54560 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
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 from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $618.02 | RVU26D |
| 2026-07-01 | Not available in this setting | $618.02 | RVU26C |
| 2026-04-01 | Not available in this setting | $618.02 | RVU26B |
| 2026-01-01 | Not available in this setting | $618.02 | RVU26A |
| 2025-10-01 | Not available in this setting | $668.83 | RVU25D |
| 2025-07-01 | Not available in this setting | $668.83 | RVU25C |
| 2025-04-01 | Not available in this setting | $668.83 | RVU25B |
| 2025-01-01 | Not available in this setting | $668.83 | RVU25A |
54560 billing questions
When should 54560 be reported instead of a testicular biopsy code?
Use 54560 when the operative service is exploration of the testis, whether or not a biopsy is taken. A biopsy code is for a biopsy service without the broader testicular exploration.
Does 54560 include a biopsy performed during the exploration?
Yes. The exploration code includes the option of taking a biopsy during the procedure; do not report a separate biopsy code for that work.
How is bilateral exploration reported?
CMS lists bilateral reporting with modifier 50 and payment at 150%. The operative documentation should support that both testes were explored.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
CMS permits assistant-at-surgery payment. Co-surgeon payment requires supporting documentation; 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.
6,31354530,,Removal of testis,A,,8.25,4.69,NA,4.69,,1.11,14.05,14.05,0,090,0.10,0.80,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,31454535,,Extensive testis surgery,A,,12.86,5.66,NA,5.66,,1.65,20.17,20.17,0,090,0.10,0.80,0.10,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,31554550,,Exploration for testis,A,,8.20,4.25,NA,4.25,,1.07,13.52,13.52,0,090,0.10,0.80,0.10,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,31654560,,Exploration for testis,A,,11.80,5.36,NA,5.36,,1.50,18.66,18.66,0,090,0.10,0.80,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,31754600,,Reduce testis torsion,A,,7.45,4.08,NA,4.08,,0.96,12.49,12.49,0,090,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,31854620,,Suspension of testis,A,,5.08,2.43,NA,2.43,,0.65,8.16,8.16,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,31954640,,Orchiopexy ingun/scrot appr,A,,7.54,3.20,NA,3.20,,1.05,11.79,11.79,0,090,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503