54520 Testis removal Medicare reimbursement rates in California

A urologist typically performs this operation in a hospital or ambulatory surgery setting to remove a testis, including by a subcapsular technique. It may be selected when the testis is being removed for a condition not requiring the radical tumor operation represented by a different code. The code encompasses the simple removal whether the surgeon uses a scrotal or inguinal approach, and allows for removal with or without a testicular prosthesis.

Choose the code based on the operation documented, not simply the diagnosis or incision: the record should support removal of the testis and distinguish a simple procedure from partial removal, limited lesion excision, or radical tumor surgery. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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 surgery, modifier 50 is paid at 150%. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.