No office rate
54860 is the unilateral procedure. Use 54861 when both epididymides are removed; do not report modifier 50 with 54861.
On this page
CMS RVU26D · Effective 2026-10-01
54861 in Redding
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$522.20
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 54861: Bilateral epididymectomy
Reported for operative removal of both epididymides when bilateral disease or symptoms require definitive surgical treatment rather than unilateral excision or focal lesion removal.
A urologist removes the epididymis on each side during an operation, generally in a facility setting. The procedure may be considered when both sides have disease or persistent symptoms requiring surgical treatment; it is more extensive than removing a localized cyst or other lesion. The operative report should establish that both epididymides were removed and describe the bilateral indication and procedure performed.
Report the bilateral service once; modifier 50 is inappropriate. When other procedures are performed in the same session, CMS applies the standard multiple procedure reduction: the highest-valued procedure is paid in full and the others at 50%. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. Assistant-at-surgery payment requires documented medical necessity. CMS does not permit co-surgeons or team surgery for this code.
CMS billing rules for 54861
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- 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 RVU9.46 · 61%
- Practice expense (office) RVU4.89 · 31%
- Malpractice RVU1.22 · 8%
28
Medicare services in 2024 · #5711 by national volume
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.
54861 compared with similar codes
Office rates for Redding, from the same CMS release.
No office rate
54830 addresses removal of a localized epididymal lesion. 54861 represents removal of both epididymides, not just a focal abnormality.
No office rate
54840 is directed to a spermatocele. Choose 54861 only when the operation removes both epididymides rather than treating the spermatocele alone.
No office rate
54865 describes exploration of the epididymis. It does not represent the bilateral removal performed under 54861.
The same code, a different location
How does Redding compare?
54861 across payment areas
Same release and payment basis · bars start at $0
Redding · 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.
Unavailable
No comparable rate is available in this setting.
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
Madera
California · 54861
Office
Unavailable
Facility
$522.20
No comparable office rate is available.
Merced
California · 54861
Office
Unavailable
Facility
$522.20
No comparable office rate is available.
Modesto
California · 54861
Office
Unavailable
Facility
$522.20
No comparable office rate is available.
Napa
California · 54861
Office
Unavailable
Facility
$571.85
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 54861
Office
Unavailable
Facility
$543.26
No comparable office rate is available.
Rest Of California
California · 54861
Office
Unavailable
Facility
$522.20
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 54861
Office
Unavailable
Facility
$535.43
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 54861
Office
Unavailable
Facility
$539.14
No comparable office rate is available.
Salinas
California · 54861
Office
Unavailable
Facility
$536.91
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 54861
Office
Unavailable
Facility
$542.88
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 54861
Office
Unavailable
Facility
$594.99
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 54861
Office
Unavailable
Facility
$593.60
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 54861
Office
Unavailable
Facility
$608.09
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 54861
Office
Unavailable
Facility
$602.43
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 54861
Office
Unavailable
Facility
$529.22
No comparable office rate is available.
Santa Cruz-Watsonville
California · 54861
Office
Unavailable
Facility
$542.90
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 54861
Office
Unavailable
Facility
$537.10
No comparable office rate is available.
Santa Rosa-Petaluma
California · 54861
Office
Unavailable
Facility
$547.86
No comparable office rate is available.
Stockton
California · 54861
Office
Unavailable
Facility
$522.20
No comparable office rate is available.
Vallejo
California · 54861
Office
Unavailable
Facility
$569.85
No comparable office rate is available.
Visalia
California · 54861
Office
Unavailable
Facility
$522.20
No comparable office rate is available.
Yuba City
California · 54861
Office
Unavailable
Facility
$522.20
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 54861
Office
Unavailable
Facility
$570.79
No comparable office rate is available.
Miami
Florida · 54861
Office
Unavailable
Facility
$589.05
No comparable office rate is available.
Chicago
Illinois · 54861
Office
Unavailable
Facility
$575.85
No comparable office rate is available.
Manhattan
New York · 54861
Office
Unavailable
Facility
$590.61
No comparable office rate is available.
Alaska*
Alaska · 54861
Office
Unavailable
Facility
$670.36
No comparable office rate is available.
Alabama
Alabama · 54861
Office
Unavailable
Facility
$481.95
No comparable office rate is available.
Arkansas
Arkansas · 54861
Office
Unavailable
Facility
$477.26
No comparable office rate is available.
Arizona
Arizona · 54861
Office
Unavailable
Facility
$509.12
No comparable office rate is available.
Colorado
Colorado · 54861
Office
Unavailable
Facility
$525.37
No comparable office rate is available.
Connecticut
Connecticut · 54861
Office
Unavailable
Facility
$547.51
No comparable office rate is available.
Delaware
Delaware · 54861
Office
Unavailable
Facility
$515.56
No comparable office rate is available.
Fort Lauderdale
Florida · 54861
Office
Unavailable
Facility
$555.10
No comparable office rate is available.
Rest Of Florida
Florida · 54861
Office
Unavailable
Facility
$533.36
No comparable office rate is available.
Atlanta
Georgia · 54861
Office
Unavailable
Facility
$531.80
No comparable office rate is available.
Rest Of Georgia
Georgia · 54861
Office
Unavailable
Facility
$510.24
No comparable office rate is available.
Hawaii, Guam
Hawaii · 54861
Office
Unavailable
Facility
$525.27
No comparable office rate is available.
Iowa
Iowa · 54861
Office
Unavailable
Facility
$481.60
No comparable office rate is available.
Idaho
Idaho · 54861
Office
Unavailable
Facility
$485.51
No comparable office rate is available.
East St. Louis
Illinois · 54861
Office
Unavailable
Facility
$548.31
No comparable office rate is available.
Rest Of Illinois
Illinois · 54861
Office
Unavailable
Facility
$528.78
No comparable office rate is available.
Suburban Chicago
Illinois · 54861
Office
Unavailable
Facility
$558.13
No comparable office rate is available.
Indiana
Indiana · 54861
Office
Unavailable
Facility
$487.18
No comparable office rate is available.
Kansas
Kansas · 54861
Office
Unavailable
Facility
$484.16
No comparable office rate is available.
Kentucky
Kentucky · 54861
Office
Unavailable
Facility
$498.46
No comparable office rate is available.
New Orleans
Louisiana · 54861
Office
Unavailable
Facility
$515.96
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 54861
Office
Unavailable
Facility
$499.56
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 54861
Office
Unavailable
Facility
$560.21
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 54861
Office
Unavailable
Facility
$525.49
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 54861
Office
Unavailable
Facility
$546.69
No comparable office rate is available.
Rest Of Maryland
Maryland · 54861
Office
Unavailable
Facility
$521.83
No comparable office rate is available.
Rest Of Maine
Maine · 54861
Office
Unavailable
Facility
$491.58
No comparable office rate is available.
Southern Maine
Maine · 54861
Office
Unavailable
Facility
$503.55
No comparable office rate is available.
Detroit
Michigan · 54861
Office
Unavailable
Facility
$542.29
No comparable office rate is available.
Rest Of Michigan
Michigan · 54861
Office
Unavailable
Facility
$511.10
No comparable office rate is available.
Minnesota
Minnesota · 54861
Office
Unavailable
Facility
$496.10
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 54861
Office
Unavailable
Facility
$509.15
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 54861
Office
Unavailable
Facility
$512.29
No comparable office rate is available.
Rest Of Missouri
Missouri · 54861
Office
Unavailable
Facility
$496.45
No comparable office rate is available.
Mississippi
Mississippi · 54861
Office
Unavailable
Facility
$486.71
No comparable office rate is available.
Montana**
Montana · 54861
Office
Unavailable
Facility
$519.97
No comparable office rate is available.
North Carolina
North Carolina · 54861
Office
Unavailable
Facility
$494.40
No comparable office rate is available.
North Dakota**
North Dakota · 54861
Office
Unavailable
Facility
$495.85
No comparable office rate is available.
Nebraska
Nebraska · 54861
Office
Unavailable
Facility
$482.13
No comparable office rate is available.
New Hampshire
New Hampshire · 54861
Office
Unavailable
Facility
$521.65
No comparable office rate is available.
Northern Nj
New Jersey · 54861
Office
Unavailable
Facility
$568.86
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 54861
Office
Unavailable
Facility
$551.67
No comparable office rate is available.
New Mexico
New Mexico · 54861
Office
Unavailable
Facility
$514.69
No comparable office rate is available.
Nevada**
Nevada · 54861
Office
Unavailable
Facility
$513.41
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 54861
Office
Unavailable
Facility
$606.07
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 54861
Office
Unavailable
Facility
$558.34
No comparable office rate is available.
Queens
New York · 54861
Office
Unavailable
Facility
$588.01
No comparable office rate is available.
Rest Of New York
New York · 54861
Office
Unavailable
Facility
$499.78
No comparable office rate is available.
Ohio
Ohio · 54861
Office
Unavailable
Facility
$506.17
No comparable office rate is available.
Oklahoma
Oklahoma · 54861
Office
Unavailable
Facility
$493.49
No comparable office rate is available.
Portland
Oregon · 54861
Office
Unavailable
Facility
$532.81
No comparable office rate is available.
Rest Of Oregon
Oregon · 54861
Office
Unavailable
Facility
$507.30
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 54861
Office
Unavailable
Facility
$540.30
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 54861
Office
Unavailable
Facility
$504.42
No comparable office rate is available.
Puerto Rico
Puerto Rico · 54861
Office
Unavailable
Facility
$521.24
No comparable office rate is available.
Rhode Island
Rhode Island · 54861
Office
Unavailable
Facility
$527.04
No comparable office rate is available.
South Carolina
South Carolina · 54861
Office
Unavailable
Facility
$501.53
No comparable office rate is available.
South Dakota**
South Dakota · 54861
Office
Unavailable
Facility
$492.99
No comparable office rate is available.
Tennessee
Tennessee · 54861
Office
Unavailable
Facility
$486.32
No comparable office rate is available.
Austin
Texas · 54861
Office
Unavailable
Facility
$525.51
No comparable office rate is available.
Beaumont
Texas · 54861
Office
Unavailable
Facility
$502.46
No comparable office rate is available.
Brazoria
Texas · 54861
Office
Unavailable
Facility
$512.15
No comparable office rate is available.
Dallas
Texas · 54861
Office
Unavailable
Facility
$516.46
No comparable office rate is available.
Fort Worth
Texas · 54861
Office
Unavailable
Facility
$515.35
No comparable office rate is available.
Galveston
Texas · 54861
Office
Unavailable
Facility
$514.43
No comparable office rate is available.
Houston
Texas · 54861
Office
Unavailable
Facility
$536.76
No comparable office rate is available.
Rest Of Texas
Texas · 54861
Office
Unavailable
Facility
$507.77
No comparable office rate is available.
Utah
Utah · 54861
Office
Unavailable
Facility
$506.10
No comparable office rate is available.
Virginia
Virginia · 54861
Office
Unavailable
Facility
$505.30
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 54861
Office
Unavailable
Facility
$521.24
No comparable office rate is available.
Vermont
Vermont · 54861
Office
Unavailable
Facility
$498.29
No comparable office rate is available.
Rest Of Washington
Washington · 54861
Office
Unavailable
Facility
$523.08
No comparable office rate is available.
Seattle (King Cnty)
Washington · 54861
Office
Unavailable
Facility
$565.47
No comparable office rate is available.
Wisconsin
Wisconsin · 54861
Office
Unavailable
Facility
$484.99
No comparable office rate is available.
West Virginia
West Virginia · 54861
Office
Unavailable
Facility
$516.22
No comparable office rate is available.
Wyoming**
Wyoming · 54861
Office
Unavailable
Facility
$509.46
No comparable office rate is available.
See how rates vary across the country
54861 · 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?
Redding is a Medicare payment area. Our Census mapping connects it to 32 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 54861 in Redding. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$574.42
$522.20 × 110% = $574.42
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 54861 in Redding.
PPRRVU2026_Oct_nonQPP.csv
6,332
- Code
- 54861
- Physician work
- 9.46
- Practice expense
- 4.89
- Malpractice
- 1.22
GPCI2026.csv
19
- Locality
- Redding
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.46 | × 1.017 | 9.6208 |
| Practice expense | 4.89 | × 1.096 | 5.3594 |
| Malpractice | 1.22 | × 0.536 | 0.6539 |
| Total RVUs | 15.6342 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Redding$522.20
Open 54861 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.46 | 1.017 |
| Practice expense | 4.89 | 1.096 |
| Malpractice | 1.22 | 0.536 |
(9.46 × 1.017 + 4.89 × 1.096 + 1.22 × 0.536) × $33.4009 = $522.20
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
54861 · 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 | $522.20 | RVU26D |
| 2026-07-01 | Not available in this setting | $522.20 | RVU26C |
| 2026-04-01 | Not available in this setting | $522.20 | RVU26B |
| 2026-01-01 | Not available in this setting | $522.20 | RVU26A |
| 2025-10-01 | Not available in this setting | $561.55 | RVU25D |
| 2025-07-01 | Not available in this setting | $561.55 | RVU25C |
| 2025-04-01 | Not available in this setting | $561.55 | RVU25B |
| 2025-01-01 | Not available in this setting | $561.55 | RVU25A |
54861 billing questions
How does this differ from 54860?
54861 describes removal on both sides; 54860 is the unilateral service. Document the side or sides treated in the operative report.
Should modifier 50 be appended?
No. The bilateral service is represented by this code, and CMS identifies modifier 50 as inappropriate.
Can a localized epididymal lesion be coded with this procedure?
A focused removal of an epididymal lesion or spermatocele is distinct from removing both epididymides. The operative report should support the actual extent of surgery.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
When is an assistant at surgery payable?
CMS allows assistant-at-surgery payment only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.
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.
6,32954830,,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
6,33254861,,Removal of epididymis,A,,9.46,4.89,NA,4.89,,1.22,15.57,15.57,0,090,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,33354865,,Explore epididymis,A,,5.63,3.71,NA,3.71,,0.72,10.06,10.06,0,090,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,33454900,,Fusion of spermatic ducts,A,,13.85,6.08,NA,6.08,,1.77,21.70,21.70,0,090,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,33554901,,Fusion of spermatic ducts,A,,18.62,7.46,NA,7.46,,2.40,28.48,28.48,0,090,0.10,0.80,0.10,2,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623
1901112,CA,61,REDDING,1.017,1.096,0.536
2001112,CA,62,RIVERSIDE-SAN BERNARDINO-ONTARIO,1.018,1.096,0.853
2101112,CA,63,SACRAMENTO-ROSEVILLE-FOLSOM,1.036,1.163,0.536
2201112,CA,64,SALINAS,1.031,1.159,0.536