Billing code 54840: Spermatocele removalMedicare rate & RVUs in Colorado
Reports surgical removal of a spermatocele arising from the epididymis, including cases where the surgeon also removes epididymal tissue.
CMS doesn’t publish an office rate for 54840 in Colorado.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 54840 covers
A urologist typically performs this scrotal operation to remove a spermatocele, a fluid-filled cyst arising from the epididymis. The procedure may include removal of epididymal tissue when needed to excise the cyst. It is commonly performed in an operating room or ambulatory surgery setting for a symptomatic or enlarging spermatocele.
Choose this code when the operative report documents excision of a spermatocele; removal of epididymal tissue as part of that excision is included. Document the cyst’s location and the work performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When other procedures occur in the same session, the highest-valued procedure is paid in full and additional procedures are subject to the standard multiple-procedure reduction. For bilateral reporting with modifier 50, Medicare pays at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
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.
54840 in Colorado
| Payment locality | Office | Facility |
|---|---|---|
| Colorado | Unavailable | $302.55 |
How the 54840 rate is calculated
Each of 54840’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 54840
RVUs × geographic indexes × conversion factor
Work5.14
5.14 RVUs× 1.000 GPCI
Practice expense3.14
3.14 RVUs× 1.000 GPCI
Malpractice0.66
0.66 RVUs× 1.000 GPCI
Adjusted RVUs
8.9400
Conversion factor
$33.4009
Medicare rate
$298.60
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 54840
54840 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 54840
Spermatocele removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 54840
Spermatocele removal
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
54840 without 50 · national facility
$298.60
Spermatocele removal
54840-50 · Bilateral: 150%
$447.90
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
54840 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 54830Epididymal lesion
- 54840 is for spermatocele excision. Use 54830 for excision of a different epididymal lesion.
- 54800Epididymal biopsy
- 54800 represents epididymal biopsy for sampling; 54840 represents surgical removal of a spermatocele.
- 54860Epididymectomy
- 54860 is for unilateral removal of the epididymis, rather than excision of a spermatocele with or without removal of epididymal tissue.
54840 billing questions
How is 54840 different from 54830?
Use 54840 for excision of a spermatocele. Code 54830 describes excision of another epididymal lesion, rather than a spermatocele.
Can epididymectomy be reported separately with 54840?
The spermatocele excision may include removal of epididymal tissue. Do not separately report an epididymectomy for tissue removal that is part of excising the spermatocele.
When is 54800 more appropriate?
Use 54800 when the service is an epididymal biopsy for tissue sampling, rather than surgical excision of a spermatocele.
What supports reporting 54840?
The operative note should identify a spermatocele and document its excision, including the relevant epididymal site and work performed.
How does Medicare handle bilateral reporting?
When the procedure is performed bilaterally, Medicare pays 150% with modifier 50. Other procedures in the same session are subject to the multiple-procedure reduction.
Can an assistant or co-surgeon be billed?
Medicare payment for an assistant at surgery is restricted 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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