No office rate
54860 describes unilateral removal; use 54861 when both epididymides are removed.
On this page
CMS RVU26D · Effective 2026-10-01
54860 in Vallejo
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$428.10
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.
Urologic surgery
About 54860: Unilateral epididymis removal
Report unilateral epididymectomy when a urologist surgically removes an epididymis, commonly to treat persistent symptomatic epididymal disease such as chronic epididymitis.
A urologist removes the epididymis through a scrotal operation, generally in a surgical facility. The procedure may be performed for persistent symptomatic epididymal disease, including chronic epididymitis causing ongoing pain despite treatment. This code represents removal of one epididymis, not sampling or excision of only a focal lesion.
Document the indication, side, and operative work showing that the epididymis was removed. For bilateral removal, report the bilateral code 54861 rather than appending modifier 50 to 54860. Medicare assigns a 90-day global period, which includes 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. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 54860
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.78 · 58%
- Practice expense (office) RVU3.95 · 34%
- Malpractice RVU0.88 · 8%
381
Medicare services in 2024 · #3778 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.
54860 compared with similar codes
Office rates for Vallejo, from the same CMS release.
No office rate
54830 is for removal of a focal epididymal lesion. Use 54860 when the operation removes the unilateral epididymis.
No office rate
54840 is directed to spermatocele excision. Choose 54860 when the documented operation removes the epididymis rather than treating only the spermatocele.
No office rate
54800 represents biopsy for tissue sampling; 54860 represents surgical removal of the unilateral epididymis.
The same code, a different location
How does Vallejo compare?
54860 across payment areas
Same release and payment basis · bars start at $0
Vallejo · 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 · 54860
Office
Unavailable
Facility
$390.66
No comparable office rate is available.
Merced
California · 54860
Office
Unavailable
Facility
$390.66
No comparable office rate is available.
Modesto
California · 54860
Office
Unavailable
Facility
$390.66
No comparable office rate is available.
Napa
California · 54860
Office
Unavailable
Facility
$429.54
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 54860
Office
Unavailable
Facility
$407.06
No comparable office rate is available.
Redding
California · 54860
Office
Unavailable
Facility
$390.66
No comparable office rate is available.
Rest Of California
California · 54860
Office
Unavailable
Facility
$390.66
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 54860
Office
Unavailable
Facility
$400.21
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 54860
Office
Unavailable
Facility
$403.80
No comparable office rate is available.
Salinas
California · 54860
Office
Unavailable
Facility
$402.14
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 54860
Office
Unavailable
Facility
$406.98
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 54860
Office
Unavailable
Facility
$447.49
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 54860
Office
Unavailable
Facility
$446.49
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 54860
Office
Unavailable
Facility
$457.37
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 54860
Office
Unavailable
Facility
$453.29
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 54860
Office
Unavailable
Facility
$396.33
No comparable office rate is available.
Santa Cruz-Watsonville
California · 54860
Office
Unavailable
Facility
$407.27
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 54860
Office
Unavailable
Facility
$402.39
No comparable office rate is available.
Santa Rosa-Petaluma
California · 54860
Office
Unavailable
Facility
$411.02
No comparable office rate is available.
Stockton
California · 54860
Office
Unavailable
Facility
$390.66
No comparable office rate is available.
Visalia
California · 54860
Office
Unavailable
Facility
$390.66
No comparable office rate is available.
Yuba City
California · 54860
Office
Unavailable
Facility
$390.66
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 54860
Office
Unavailable
Facility
$426.82
No comparable office rate is available.
Miami
Florida · 54860
Office
Unavailable
Facility
$438.14
No comparable office rate is available.
Chicago
Illinois · 54860
Office
Unavailable
Facility
$428.09
No comparable office rate is available.
Manhattan
New York · 54860
Office
Unavailable
Facility
$440.88
No comparable office rate is available.
Alaska*
Alaska · 54860
Office
Unavailable
Facility
$496.39
No comparable office rate is available.
Alabama
Alabama · 54860
Office
Unavailable
Facility
$358.54
No comparable office rate is available.
Arkansas
Arkansas · 54860
Office
Unavailable
Facility
$354.93
No comparable office rate is available.
Arizona
Arizona · 54860
Office
Unavailable
Facility
$379.46
No comparable office rate is available.
Colorado
Colorado · 54860
Office
Unavailable
Facility
$392.51
No comparable office rate is available.
Connecticut
Connecticut · 54860
Office
Unavailable
Facility
$408.64
No comparable office rate is available.
Delaware
Delaware · 54860
Office
Unavailable
Facility
$384.36
No comparable office rate is available.
Fort Lauderdale
Florida · 54860
Office
Unavailable
Facility
$413.25
No comparable office rate is available.
Rest Of Florida
Florida · 54860
Office
Unavailable
Facility
$396.76
No comparable office rate is available.
Atlanta
Georgia · 54860
Office
Unavailable
Facility
$396.48
No comparable office rate is available.
Rest Of Georgia
Georgia · 54860
Office
Unavailable
Facility
$379.18
No comparable office rate is available.
Hawaii, Guam
Hawaii · 54860
Office
Unavailable
Facility
$393.48
No comparable office rate is available.
Iowa
Iowa · 54860
Office
Unavailable
Facility
$358.85
No comparable office rate is available.
Idaho
Idaho · 54860
Office
Unavailable
Facility
$361.74
No comparable office rate is available.
East St. Louis
Illinois · 54860
Office
Unavailable
Facility
$407.03
No comparable office rate is available.
Rest Of Illinois
Illinois · 54860
Office
Unavailable
Facility
$392.85
No comparable office rate is available.
Suburban Chicago
Illinois · 54860
Office
Unavailable
Facility
$415.62
No comparable office rate is available.
Indiana
Indiana · 54860
Office
Unavailable
Facility
$363.05
No comparable office rate is available.
Kansas
Kansas · 54860
Office
Unavailable
Facility
$360.54
No comparable office rate is available.
Kentucky
Kentucky · 54860
Office
Unavailable
Facility
$370.64
No comparable office rate is available.
New Orleans
Louisiana · 54860
Office
Unavailable
Facility
$384.00
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 54860
Office
Unavailable
Facility
$371.38
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 54860
Office
Unavailable
Facility
$419.43
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 54860
Office
Unavailable
Facility
$392.43
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 54860
Office
Unavailable
Facility
$408.01
No comparable office rate is available.
Rest Of Maryland
Maryland · 54860
Office
Unavailable
Facility
$389.22
No comparable office rate is available.
Rest Of Maine
Maine · 54860
Office
Unavailable
Facility
$366.12
No comparable office rate is available.
Southern Maine
Maine · 54860
Office
Unavailable
Facility
$375.75
No comparable office rate is available.
Detroit
Michigan · 54860
Office
Unavailable
Facility
$403.33
No comparable office rate is available.
Rest Of Michigan
Michigan · 54860
Office
Unavailable
Facility
$380.10
No comparable office rate is available.
Minnesota
Minnesota · 54860
Office
Unavailable
Facility
$370.92
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 54860
Office
Unavailable
Facility
$379.06
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 54860
Office
Unavailable
Facility
$381.51
No comparable office rate is available.
Rest Of Missouri
Missouri · 54860
Office
Unavailable
Facility
$368.81
No comparable office rate is available.
Mississippi
Mississippi · 54860
Office
Unavailable
Facility
$361.77
No comparable office rate is available.
Montana**
Montana · 54860
Office
Unavailable
Facility
$387.73
No comparable office rate is available.
North Carolina
North Carolina · 54860
Office
Unavailable
Facility
$368.33
No comparable office rate is available.
North Dakota**
North Dakota · 54860
Office
Unavailable
Facility
$370.33
No comparable office rate is available.
Nebraska
Nebraska · 54860
Office
Unavailable
Facility
$359.34
No comparable office rate is available.
New Hampshire
New Hampshire · 54860
Office
Unavailable
Facility
$389.52
No comparable office rate is available.
Northern Nj
New Jersey · 54860
Office
Unavailable
Facility
$425.16
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 54860
Office
Unavailable
Facility
$411.83
No comparable office rate is available.
New Mexico
New Mexico · 54860
Office
Unavailable
Facility
$382.74
No comparable office rate is available.
Nevada**
Nevada · 54860
Office
Unavailable
Facility
$383.01
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 54860
Office
Unavailable
Facility
$452.40
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 54860
Office
Unavailable
Facility
$416.68
No comparable office rate is available.
Queens
New York · 54860
Office
Unavailable
Facility
$439.28
No comparable office rate is available.
Rest Of New York
New York · 54860
Office
Unavailable
Facility
$372.46
No comparable office rate is available.
Ohio
Ohio · 54860
Office
Unavailable
Facility
$376.54
No comparable office rate is available.
Oklahoma
Oklahoma · 54860
Office
Unavailable
Facility
$367.11
No comparable office rate is available.
Portland
Oregon · 54860
Office
Unavailable
Facility
$398.53
No comparable office rate is available.
Rest Of Oregon
Oregon · 54860
Office
Unavailable
Facility
$378.53
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 54860
Office
Unavailable
Facility
$402.94
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 54860
Office
Unavailable
Facility
$375.35
No comparable office rate is available.
Puerto Rico
Puerto Rico · 54860
Office
Unavailable
Facility
$388.79
No comparable office rate is available.
Rhode Island
Rhode Island · 54860
Office
Unavailable
Facility
$393.27
No comparable office rate is available.
South Carolina
South Carolina · 54860
Office
Unavailable
Facility
$373.35
No comparable office rate is available.
South Dakota**
South Dakota · 54860
Office
Unavailable
Facility
$368.27
No comparable office rate is available.
Tennessee
Tennessee · 54860
Office
Unavailable
Facility
$362.17
No comparable office rate is available.
Austin
Texas · 54860
Office
Unavailable
Facility
$392.54
No comparable office rate is available.
Beaumont
Texas · 54860
Office
Unavailable
Facility
$373.82
No comparable office rate is available.
Brazoria
Texas · 54860
Office
Unavailable
Facility
$381.94
No comparable office rate is available.
Dallas
Texas · 54860
Office
Unavailable
Facility
$385.12
No comparable office rate is available.
Fort Worth
Texas · 54860
Office
Unavailable
Facility
$384.18
No comparable office rate is available.
Galveston
Texas · 54860
Office
Unavailable
Facility
$383.62
No comparable office rate is available.
Houston
Texas · 54860
Office
Unavailable
Facility
$399.72
No comparable office rate is available.
Rest Of Texas
Texas · 54860
Office
Unavailable
Facility
$378.20
No comparable office rate is available.
Utah
Utah · 54860
Office
Unavailable
Facility
$376.87
No comparable office rate is available.
Virginia
Virginia · 54860
Office
Unavailable
Facility
$376.90
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 54860
Office
Unavailable
Facility
$388.79
No comparable office rate is available.
Vermont
Vermont · 54860
Office
Unavailable
Facility
$371.95
No comparable office rate is available.
Rest Of Washington
Washington · 54860
Office
Unavailable
Facility
$390.70
No comparable office rate is available.
Seattle (King Cnty)
Washington · 54860
Office
Unavailable
Facility
$423.68
No comparable office rate is available.
Wisconsin
Wisconsin · 54860
Office
Unavailable
Facility
$361.90
No comparable office rate is available.
West Virginia
West Virginia · 54860
Office
Unavailable
Facility
$383.17
No comparable office rate is available.
Wyoming**
Wyoming · 54860
Office
Unavailable
Facility
$380.14
No comparable office rate is available.
See how rates vary across the country
54860 · 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?
Vallejo is a Medicare payment area. Our Census mapping connects it to 11 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 54860 in Vallejo. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$470.91
$428.10 × 110% = $470.91
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 54860 in Vallejo.
PPRRVU2026_Oct_nonQPP.csv
6,331
- Code
- 54860
- Physician work
- 6.78
- Practice expense
- 3.95
- Malpractice
- 0.88
GPCI2026.csv
33
- Locality
- Vallejo
- Physician work
- 1.063
- Practice expense
- 1.318
- Malpractice
- 0.459
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.78 | × 1.063 | 7.2071 |
| Practice expense | 3.95 | × 1.318 | 5.2061 |
| Malpractice | 0.88 | × 0.459 | 0.4039 |
| Total RVUs | 12.8172 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vallejo$428.10
Open 54860 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.78 | 1.063 |
| Practice expense | 3.95 | 1.318 |
| Malpractice | 0.88 | 0.459 |
(6.78 × 1.063 + 3.95 × 1.318 + 0.88 × 0.459) × $33.4009 = $428.10
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
54860 · 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 | $428.10 | RVU26D |
| 2026-07-01 | Not available in this setting | $428.10 | RVU26C |
| 2026-04-01 | Not available in this setting | $428.10 | RVU26B |
| 2026-01-01 | Not available in this setting | $428.10 | RVU26A |
| 2025-10-01 | Not available in this setting | $458.52 | RVU25D |
| 2025-07-01 | Not available in this setting | $458.52 | RVU25C |
| 2025-04-01 | Not available in this setting | $458.52 | RVU25B |
| 2025-01-01 | Not available in this setting | $458.52 | RVU25A |
54860 billing questions
When should 54860 be chosen instead of a lesion-excision code?
Use 54860 when the operation removes the unilateral epididymis. A procedure limited to a focal epididymal lesion is represented by a lesion-excision code.
How is bilateral epididymectomy reported?
Use 54861 for bilateral removal rather than reporting 54860 with modifier 50.
Does the 90-day global include related postoperative care?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be billed?
Medicare does not pay an assistant at surgery for 54860. Co-surgeons and team surgery are not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in that session are subject to the standard multiple-procedure reduction.
What documentation supports reporting 54860?
Document the condition prompting surgery, the side treated, and operative findings and work confirming removal of the epididymis rather than biopsy or focal lesion excision.
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.
6,32854800,,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
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
3001182,CA,74,SANTA MARIA-SANTA BARBARA,1.028,1.166,0.536
3101112,CA,67,SANTA ROSA-PETALUMA,1.030,1.228,0.536
3201112,CA,68,STOCKTON,1.017,1.096,0.536
3301112,CA,53,VALLEJO,1.063,1.318,0.459
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536