No office rate
54800 represents tissue sampling for diagnosis; 54830 is for excision of a defined epididymal lesion.
On this page
CMS RVU26D · Effective 2026-10-01
54800 in El Centro
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$110.72
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 54800: Epididymal tissue biopsy
A surgeon samples epididymal tissue for histopathologic evaluation when a focal abnormality requires tissue diagnosis rather than lesion excision or epididymis removal.
A urologist obtains a tissue sample from the epididymis for pathologic examination, commonly to evaluate an abnormal area that requires a tissue diagnosis. The service involves sampling epididymal tissue; it is distinct from removing a defined lesion, excising a spermatocele, or removing the epididymis. It may be performed in an operating room or an ambulatory surgical setting.
Report 54800 when the documented service is an epididymal biopsy, and retain the operative note describing the sampled site, laterality, clinical indication, and tissue submitted for examination. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral biopsy, modifier 50 is paid at 150%. An assistant is paid only when medical necessity is documented; co-surgeons and team surgery are not permitted.
CMS billing rules for 54800
- 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.27 · 68%
- Practice expense (office) RVU0.78 · 23%
- Malpractice RVU0.28 · 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.
54800 compared with similar codes
Office rates for El Centro, from the same CMS release.
No office rate
Choose 54840 for spermatocele excision, with or without epididymectomy; 54800 describes a biopsy rather than removal of the spermatocele.
No office rate
54860 is unilateral removal of the epididymis. Use 54800 when the service is limited to obtaining tissue for diagnosis.
No office rate
54865 describes epididymal exploration and includes the possibility of biopsy. Do not separately report 54800 for biopsy work included in the exploration.
The same code, a different location
How does El Centro compare?
54800 across payment areas
Same release and payment basis · bars start at $0
El Centro · This locality
Unavailable
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.
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in California 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
Merced
California · 54800
Office
Unavailable
Facility
$110.68
No comparable office rate is available.
Modesto
California · 54800
Office
Unavailable
Facility
$110.68
No comparable office rate is available.
Napa
California · 54800
Office
Unavailable
Facility
$119.69
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 54800
Office
Unavailable
Facility
$114.56
No comparable office rate is available.
Redding
California · 54800
Office
Unavailable
Facility
$110.68
No comparable office rate is available.
Rest Of California
California · 54800
Office
Unavailable
Facility
$110.68
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 54800
Office
Unavailable
Facility
$113.72
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 54800
Office
Unavailable
Facility
$113.86
No comparable office rate is available.
Salinas
California · 54800
Office
Unavailable
Facility
$113.38
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 54800
Office
Unavailable
Facility
$114.32
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 54800
Office
Unavailable
Facility
$124.05
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 54800
Office
Unavailable
Facility
$123.73
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 54800
Office
Unavailable
Facility
$126.74
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 54800
Office
Unavailable
Facility
$125.44
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 54800
Office
Unavailable
Facility
$111.80
No comparable office rate is available.
Santa Cruz-Watsonville
California · 54800
Office
Unavailable
Facility
$114.08
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 54800
Office
Unavailable
Facility
$113.33
No comparable office rate is available.
Santa Rosa-Petaluma
California · 54800
Office
Unavailable
Facility
$115.10
No comparable office rate is available.
Stockton
California · 54800
Office
Unavailable
Facility
$110.68
No comparable office rate is available.
Vallejo
California · 54800
Office
Unavailable
Facility
$119.23
No comparable office rate is available.
Visalia
California · 54800
Office
Unavailable
Facility
$110.68
No comparable office rate is available.
Yuba City
California · 54800
Office
Unavailable
Facility
$110.68
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 54800
Office
Unavailable
Facility
$121.01
No comparable office rate is available.
Miami
Florida · 54800
Office
Unavailable
Facility
$126.59
No comparable office rate is available.
Chicago
Illinois · 54800
Office
Unavailable
Facility
$124.00
No comparable office rate is available.
Manhattan
New York · 54800
Office
Unavailable
Facility
$125.78
No comparable office rate is available.
Alaska*
Alaska · 54800
Office
Unavailable
Facility
$146.63
No comparable office rate is available.
Alabama
Alabama · 54800
Office
Unavailable
Facility
$103.91
No comparable office rate is available.
Arkansas
Arkansas · 54800
Office
Unavailable
Facility
$103.02
No comparable office rate is available.
Arizona
Arizona · 54800
Office
Unavailable
Facility
$109.07
No comparable office rate is available.
Colorado
Colorado · 54800
Office
Unavailable
Facility
$111.75
No comparable office rate is available.
Connecticut
Connecticut · 54800
Office
Unavailable
Facility
$116.71
No comparable office rate is available.
Delaware
Delaware · 54800
Office
Unavailable
Facility
$110.35
No comparable office rate is available.
Fort Lauderdale
Florida · 54800
Office
Unavailable
Facility
$119.12
No comparable office rate is available.
Rest Of Florida
Florida · 54800
Office
Unavailable
Facility
$114.78
No comparable office rate is available.
Atlanta
Georgia · 54800
Office
Unavailable
Facility
$113.75
No comparable office rate is available.
Rest Of Georgia
Georgia · 54800
Office
Unavailable
Facility
$110.21
No comparable office rate is available.
Hawaii, Guam
Hawaii · 54800
Office
Unavailable
Facility
$110.86
No comparable office rate is available.
Iowa
Iowa · 54800
Office
Unavailable
Facility
$103.37
No comparable office rate is available.
Idaho
Idaho · 54800
Office
Unavailable
Facility
$104.21
No comparable office rate is available.
East St. Louis
Illinois · 54800
Office
Unavailable
Facility
$118.62
No comparable office rate is available.
Rest Of Illinois
Illinois · 54800
Office
Unavailable
Facility
$114.22
No comparable office rate is available.
Suburban Chicago
Illinois · 54800
Office
Unavailable
Facility
$119.68
No comparable office rate is available.
Indiana
Indiana · 54800
Office
Unavailable
Facility
$104.52
No comparable office rate is available.
Kansas
Kansas · 54800
Office
Unavailable
Facility
$104.09
No comparable office rate is available.
Kentucky
Kentucky · 54800
Office
Unavailable
Facility
$107.54
No comparable office rate is available.
New Orleans
Louisiana · 54800
Office
Unavailable
Facility
$110.96
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 54800
Office
Unavailable
Facility
$107.84
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 54800
Office
Unavailable
Facility
$118.36
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 54800
Office
Unavailable
Facility
$111.92
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 54800
Office
Unavailable
Facility
$116.56
No comparable office rate is available.
Rest Of Maryland
Maryland · 54800
Office
Unavailable
Facility
$111.53
No comparable office rate is available.
Rest Of Maine
Maine · 54800
Office
Unavailable
Facility
$105.61
No comparable office rate is available.
Southern Maine
Maine · 54800
Office
Unavailable
Facility
$107.54
No comparable office rate is available.
Detroit
Michigan · 54800
Office
Unavailable
Facility
$116.73
No comparable office rate is available.
Rest Of Michigan
Michigan · 54800
Office
Unavailable
Facility
$110.16
No comparable office rate is available.
Minnesota
Minnesota · 54800
Office
Unavailable
Facility
$105.40
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 54800
Office
Unavailable
Facility
$109.42
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 54800
Office
Unavailable
Facility
$109.99
No comparable office rate is available.
Rest Of Missouri
Missouri · 54800
Office
Unavailable
Facility
$107.39
No comparable office rate is available.
Mississippi
Mississippi · 54800
Office
Unavailable
Facility
$105.16
No comparable office rate is available.
Montana**
Montana · 54800
Office
Unavailable
Facility
$111.21
No comparable office rate is available.
North Carolina
North Carolina · 54800
Office
Unavailable
Facility
$106.10
No comparable office rate is available.
North Dakota**
North Dakota · 54800
Office
Unavailable
Facility
$105.67
No comparable office rate is available.
Nebraska
Nebraska · 54800
Office
Unavailable
Facility
$103.40
No comparable office rate is available.
New Hampshire
New Hampshire · 54800
Office
Unavailable
Facility
$111.12
No comparable office rate is available.
Northern Nj
New Jersey · 54800
Office
Unavailable
Facility
$120.81
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 54800
Office
Unavailable
Facility
$117.56
No comparable office rate is available.
New Mexico
New Mexico · 54800
Office
Unavailable
Facility
$110.94
No comparable office rate is available.
Nevada**
Nevada · 54800
Office
Unavailable
Facility
$109.69
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 54800
Office
Unavailable
Facility
$129.02
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 54800
Office
Unavailable
Facility
$119.08
No comparable office rate is available.
Queens
New York · 54800
Office
Unavailable
Facility
$124.95
No comparable office rate is available.
Rest Of New York
New York · 54800
Office
Unavailable
Facility
$107.14
No comparable office rate is available.
Ohio
Ohio · 54800
Office
Unavailable
Facility
$109.03
No comparable office rate is available.
Oklahoma
Oklahoma · 54800
Office
Unavailable
Facility
$106.35
No comparable office rate is available.
Portland
Oregon · 54800
Office
Unavailable
Facility
$112.94
No comparable office rate is available.
Rest Of Oregon
Oregon · 54800
Office
Unavailable
Facility
$108.34
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 54800
Office
Unavailable
Facility
$115.46
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 54800
Office
Unavailable
Facility
$108.57
No comparable office rate is available.
Puerto Rico
Puerto Rico · 54800
Office
Unavailable
Facility
$111.37
No comparable office rate is available.
Rhode Island
Rhode Island · 54800
Office
Unavailable
Facility
$112.52
No comparable office rate is available.
South Carolina
South Carolina · 54800
Office
Unavailable
Facility
$107.84
No comparable office rate is available.
South Dakota**
South Dakota · 54800
Office
Unavailable
Facility
$105.02
No comparable office rate is available.
Tennessee
Tennessee · 54800
Office
Unavailable
Facility
$104.52
No comparable office rate is available.
Austin
Texas · 54800
Office
Unavailable
Facility
$111.82
No comparable office rate is available.
Beaumont
Texas · 54800
Office
Unavailable
Facility
$108.22
No comparable office rate is available.
Brazoria
Texas · 54800
Office
Unavailable
Facility
$109.54
No comparable office rate is available.
Dallas
Texas · 54800
Office
Unavailable
Facility
$110.48
No comparable office rate is available.
Fort Worth
Texas · 54800
Office
Unavailable
Facility
$110.34
No comparable office rate is available.
Galveston
Texas · 54800
Office
Unavailable
Facility
$110.04
No comparable office rate is available.
Houston
Texas · 54800
Office
Unavailable
Facility
$115.17
No comparable office rate is available.
Rest Of Texas
Texas · 54800
Office
Unavailable
Facility
$108.99
No comparable office rate is available.
Utah
Utah · 54800
Office
Unavailable
Facility
$108.71
No comparable office rate is available.
Virginia
Virginia · 54800
Office
Unavailable
Facility
$108.03
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 54800
Office
Unavailable
Facility
$111.37
No comparable office rate is available.
Vermont
Vermont · 54800
Office
Unavailable
Facility
$106.34
No comparable office rate is available.
Rest Of Washington
Washington · 54800
Office
Unavailable
Facility
$111.36
No comparable office rate is available.
Seattle (King Cnty)
Washington · 54800
Office
Unavailable
Facility
$119.22
No comparable office rate is available.
Wisconsin
Wisconsin · 54800
Office
Unavailable
Facility
$103.66
No comparable office rate is available.
West Virginia
West Virginia · 54800
Office
Unavailable
Facility
$111.84
No comparable office rate is available.
Wyoming**
Wyoming · 54800
Office
Unavailable
Facility
$108.79
No comparable office rate is available.
See how rates vary across the country
54800 · 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?
El Centro is a Medicare payment area. Our Census mapping connects it to 18 cities and communities in California, 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 54800 in El Centro. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$121.79
$110.72 × 110% = $121.79
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 54800 in El Centro.
PPRRVU2026_Oct_nonQPP.csv
6,328
- Code
- 54800
- Physician work
- 2.27
- Practice expense
- 0.78
- Malpractice
- 0.28
GPCI2026.csv
10
- Locality
- El Centro
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.541
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.27 | × 1.017 | 2.3086 |
| Practice expense | 0.78 | × 1.096 | 0.8549 |
| Malpractice | 0.28 | × 0.541 | 0.1515 |
| Total RVUs | 3.3149 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, El Centro$110.72
Open 54800 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.27 | 1.017 |
| Practice expense | 0.78 | 1.096 |
| Malpractice | 0.28 | 0.541 |
(2.27 × 1.017 + 0.78 × 1.096 + 0.28 × 0.541) × $33.4009 = $110.72
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
54800 · 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 | $110.72 | RVU26D |
| 2026-07-01 | Not available in this setting | $110.72 | RVU26C |
| 2026-04-01 | Not available in this setting | $110.72 | RVU26B |
| 2026-01-01 | Not available in this setting | $110.72 | RVU26A |
| 2025-10-01 | Not available in this setting | $121.89 | RVU25D |
| 2025-07-01 | Not available in this setting | $121.89 | RVU25C |
| 2025-04-01 | Not available in this setting | $121.89 | RVU25B |
| 2025-01-01 | Not available in this setting | $121.89 | RVU25A |
54800 billing questions
How is 54800 different from excision of an epididymal lesion?
Use 54800 when tissue is sampled for diagnosis. When the surgeon removes a defined lesion, consider 54830 instead.
Can 54800 be reported with epididymal exploration?
54865 includes exploration with or without biopsy. Do not separately report 54800 for biopsy work included in that exploration.
How should bilateral biopsies be reported?
Report modifier 50 when the biopsy is performed bilaterally. CMS pays the bilateral service at 150%; document the sampled sites on both sides.
What documentation supports 54800?
The operative note should identify the epididymal site sampled, laterality, reason for biopsy, and tissue submitted for pathologic examination.
Can an assistant surgeon be paid for this procedure?
Assistant-at-surgery payment is available only when the record supports medical necessity. 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 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.
6,32554692,,Laparoscopy orchiopexy,A,,13.40,5.26,NA,5.26,,1.72,20.38,20.38,0,090,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,32654699,,Unlisted laps px testis,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
6,32754700,,I&d epdidyms tstis&/scrot sp,A,,3.38,2.13,NA,2.13,,0.48,5.99,5.99,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,32854800,,Biopsy of epididymis,A,,2.27,0.78,NA,0.78,,0.28,3.33,3.33,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,32954830,,Remove epididymis lesion,A,,5.86,3.77,NA,3.77,,0.78,10.41,10.41,0,090,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,33054840,,Remove epididymis lesion,A,,5.14,3.14,NA,3.14,,0.66,8.94,8.94,0,090,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,33154860,,Removal of epididymis,A,,6.78,3.95,NA,3.95,,0.88,11.61,11.61,0,090,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541
1101112,CA,56,FRESNO,1.017,1.096,0.536
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664