No office rate
54522 is for partial orchiectomy, with testicular tissue preserved; 54520 represents simple removal of the testis.
On this page
CMS RVU26D · Effective 2026-10-01
54520 Testis removal Medicare reimbursement rates in Colorado
Reports simple surgical removal of a testis, including a subcapsular procedure, when the treatment plan calls for removal rather than biopsy or limited lesion excision. Compare 54520 office and facility rates across CMS payment localities in Colorado.
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.
What does Medicare pay for 54520 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$309.30
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Urology surgery
About 54520: Simple orchiectomy
Reports simple surgical removal of a testis, including a subcapsular procedure, when the treatment plan calls for removal rather than biopsy or limited lesion excision.
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.
CMS billing rules for 54520
- 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
- 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 RVU5.17 · 57%
- Practice expense (office) RVU3.25 · 36%
- Malpractice RVU0.73 · 8%
1.5K
Medicare services in 2024 · #2652 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.
54520 compared with similar codes
Office rates for Colorado, from the same CMS release.
No office rate
54530 is the radical operation for a testicular tumor using an inguinal approach. Do not select it solely because the diagnosis is a tumor; the documented procedure must support radical surgery.
No office rate
54535 represents radical tumor surgery with abdominal exploration. A simple orchiectomy without that radical operation is reported with 54520.
No office rate
54512 applies when a testicular lesion is excised and the testis is preserved; 54520 applies when the testis is removed.
Compare 54520 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Colorado →
Office / nonfacility
Unavailable
Facility
$309.30
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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 54520 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
6,311
- Code
- 54520
- Physician work
- 5.17
- Practice expense
- 3.25
- Malpractice
- 0.73
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.17 | × 1.012 | 5.2320 |
| Practice expense | 3.25 | × 1.064 | 3.4580 |
| Malpractice | 0.73 | × 0.781 | 0.5701 |
| Total RVUs | 9.2602 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$309.30
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.17 | 1.012 |
| Practice expense | 3.25 | 1.064 |
| Malpractice | 0.73 | 0.781 |
(5.17 × 1.012 + 3.25 × 1.064 + 0.73 × 0.781) × $33.4009 = $309.30
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.
54520 billing questions
How is 54520 different from radical orchiectomy 54530?
Use 54520 for simple removal, including subcapsular removal. Code 54530 describes radical orchiectomy for a tumor through an inguinal approach.
Can 54520 be reported for partial removal of a testis?
No. When only part of the testis is removed, compare the operative documentation with 54522, the partial orchiectomy code.
Is removal of a small testicular lesion coded as 54520?
Not when the surgeon excises a lesion while preserving the testis; compare 54512. Report 54520 when the operation removes the testis.
How should bilateral orchiectomy be reported?
Report bilateral surgery with modifier 50. CMS pays this bilateral procedure at 150%.
What postoperative care is included in 54520?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be reported?
CMS does not pay assistant-at-surgery services for this code. 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.
6,30854500,,Biopsy of testis,A,,1.28,0.57,NA,0.57,,0.16,2.01,2.01,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,30954505,,Biopsy of testis,A,,3.41,1.94,NA,1.94,,0.43,5.78,5.78,0,010,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,31054512,,Excise lesion testis,A,,9.10,4.39,NA,4.39,,1.19,14.68,14.68,0,090,0.10,0.80,0.10,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,31154520,,Removal of testis,A,,5.17,3.25,NA,3.25,,0.73,9.15,9.15,0,090,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,31254522,,Orchiectomy partial,A,,9.99,4.74,NA,4.74,,1.29,16.02,16.02,0,090,0.10,0.80,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,31354530,,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
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
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