Billing code 54692: Laparoscopic orchiopexyMedicare rate & RVUs in Delaware

Report 54692 when a surgeon uses operative laparoscopy to locate and fix an intra-abdominal undescended testis into the scrotum.

CMS RVU26DEffective Oct 1, 20261 payment locality

CMS doesn’t publish an office rate for 54692 in Delaware.

—Office (non-facility)
$675.04Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 54692 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Delaware
  2. What 54692 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 54692 covers

A urologist, often a pediatric urologist, performs this operation for an undescended testis located within the abdomen. Through laparoscopic access, the surgeon identifies and mobilizes the testis and positions it in the scrotum. The operative report should establish the intra-abdominal location and describe the laparoscopic approach and fixation performed.

Select 54692 for laparoscopic orchiopexy, not solely because diagnostic laparoscopy was used. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery, modifier 50 is paid at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Medicare does not pay an assistant at surgery; 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.

54692 in Delaware

54692 office and facility rates by payment locality
Payment localityOfficeFacility
DelawareUnavailable$675.04

How the 54692 rate is calculated

Each of 54692’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 · 54692

RVUs × geographic indexes × conversion factor

Work13.40

13.40 RVUs× 1.000 GPCI

Practice expense5.26

5.26 RVUs× 1.000 GPCI

Malpractice1.72

1.72 RVUs× 1.000 GPCI

Adjusted RVUs

20.3800

Conversion factor

$33.4009

Medicare rate

$680.71

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 54692

54692 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 54692

Laparoscopic orchiopexy

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 54692

Laparoscopic orchiopexy

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

54692 without 50 · national facility

$680.71

Laparoscopic orchiopexy

54692-50 · Bilateral: 150%

$1,021.07

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).

When to use modifier 50

54692 compared with similar codes

Compare codes · National

4 codes, side by side

  • 54692

    Laparoscopic orchiopexy13.4 wRVU

    Not priced

  • 54650

    Orchiopexy12.08 wRVU

    Not priced

  • 54640

    Orchiopexy7.54 wRVU

    Not priced

  • 54690

    Orchiectomy11.41 wRVU

    Not priced

How to choose

54650Orchiopexy
Both address an intra-abdominal undescended testis, but 54650 is for the abdominal approach; 54692 is for operative laparoscopy.
54640Orchiopexy
Use 54640 when orchiopexy is performed through an inguinal or scrotal approach, rather than laparoscopically for an intra-abdominal testis.
54690Orchiectomy
54690 describes laparoscopic orchiectomy, which removes the testis; 54692 fixes the testis in the scrotum.

54692 billing questions

How does 54692 differ from 54650?

54692 describes laparoscopic orchiopexy for an intra-abdominal testis. Use 54650 for the abdominal approach rather than the laparoscopic approach.

Can 54692 be reported for bilateral orchiopexy?

For bilateral surgery, report modifier 50. CMS pays the bilateral procedure at 150%.

What postoperative care is included?

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

How are other same-session procedures paid?

The highest-valued procedure is paid in full, and other procedures performed in the same session are subject to the standard 50% multiple-procedure reduction.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery 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
RVUs for 54692PPRRVU2026_Oct_nonQPP.csv, line 6,325 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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