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CMS RVU26D · Effective 2026-10-01

54690 Orchiectomy Medicare reimbursement rates in Colorado

Reports laparoscopic surgical removal of a testis, including removal of an atrophic intra-abdominal testis when excision is chosen. Compare 54690 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 54690 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

$597.55

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.

Find 54690 in your payment locality →

Urology surgery

About 54690: Laparoscopic surgical removal of testis

Reports laparoscopic surgical removal of a testis, including removal of an atrophic intra-abdominal testis when excision is chosen.

A urologist performs this operation through laparoscopic access to remove a testis rather than reposition it. One typical setting is removal of an atrophic intra-abdominal testis, including in the evaluation or treatment of an undescended testis. The service is generally performed in an operating room, and the operative report should establish the laparoscopic approach and that the testis was excised.

Report the code for the laparoscopic removal itself, with documentation of the indication, laterality, and operative work. A major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care. For same-session procedures, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 54690

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
Assistant at surgery may be paid.
Co-surgeons
Co-surgeons paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU11.41 · 64%
  • Practice expense (office) RVU4.89 · 28%
  • Malpractice RVU1.46 · 8%

19

Medicare services in 2024 · #5950 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.

54690 compared with similar codes

Office rates for Colorado, from the same CMS release.

54692

Laparoscopic orchiopexy

Intra-abdominal testis

No office rate

Use 54690 when the laparoscopic procedure removes the testis; use 54692 when laparoscopic surgery repositions and secures it.

54640

Orchiopexy

Inguinal or scrotal approach

No office rate

Code 54640 is orchiopexy through an inguinal or scrotal approach to place a testis in the scrotum; 54690 removes the testis laparoscopically.

54530

Orchiectomy

Radical, inguinal approach

No office rate

Code 54530 describes radical orchiectomy by an inguinal approach. Select 54690 when the documented removal is performed laparoscopically.

Compare 54690 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

Office and facility base rates · shared scale starting at $0

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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 54690 in Colorado.

PPRRVU2026_Oct_nonQPP.csv

6,324

Code
54690
Physician work
11.41
Practice expense
4.89
Malpractice
1.46

GPCI2026.csv

37

Locality
Colorado
Physician work
1.012
Practice expense
1.064
Malpractice
0.781
Facility calculation for 54690 in Colorado
ComponentRVULocality factorAdjusted
Physician work11.41× 1.01211.5469
Practice expense4.89× 1.0645.2030
Malpractice1.46× 0.7811.1403
Total RVUs17.8901
Conversion factor× 33.4009

Facility rate, Colorado$597.55

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work11.411.012
Practice expense4.891.064
Malpractice1.460.781

(11.41 × 1.012 + 4.89 × 1.064 + 1.46 × 0.781) × $33.4009 = $597.55

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.

54690 billing questions

When should 54690 be reported instead of 54692?

Report 54690 when the testis is removed laparoscopically. Code 54692 describes laparoscopic orchiopexy, which repositions and secures a testis rather than removing it.

How is bilateral laparoscopic orchiectomy reported?

Use modifier 50 for a bilateral procedure; CMS pays this code at 150% when reported bilaterally.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery services may be paid. Co-surgeons are paid only with supporting documentation.

What should the operative note document?

Document the indication, side, laparoscopic approach, and removal of the testis. These details distinguish this service from laparoscopic orchiopexy or an open orchiectomy.

How does CMS handle other procedures performed in the same session?

The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple-procedure reduction.

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.

RVUs for 54690PPRRVU2026_Oct_nonQPP.csv, line 6,324 (RVU26D)
Geographic factors for ColoradoGPCI2026.csv, line 37 (RVU26D)