Billing code 54700: Genital abscess drainageMedicare rate & RVUs in Delaware
Reports surgical drainage of an abscess involving the epididymis, testis, or scrotal space, rather than a collection limited to the scrotal wall.
CMS doesn’t publish an office rate for 54700 in Delaware.
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 54700 covers
A urologist or other qualified surgeon uses an incision to reach and drain purulent material from an infected epididymis, testis, or scrotal space. The service is performed for a deeper genital abscess, commonly in an operating room or other surgical setting; the operative record should identify the involved structure or space and the findings supporting drainage. This code is distinct from drainage confined to the scrotal wall.
Report the service when the operative work is drainage of one or more of the named deeper sites, and document laterality and the extent of the procedure. It has a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. For bilateral reporting with modifier 50, CMS pays at 150%. CMS does not pay an assistant at surgery for this code; 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.
54700 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $198.16 |
How the 54700 rate is calculated
Each of 54700’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 · 54700
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.38Practice expense 2.13Malpractice 0.48
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 54700
54700 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 54700
Genital abscess drainage
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 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 · 54700
Genital abscess drainage
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
54700 without 50 · national facility
$200.07
Genital abscess drainage
54700-50 · Bilateral: 150%
$300.11
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).
54700 compared with similar codes
Compare codes
54700 vs 55100 vs 55110 vs 54800: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 55100Scrotal abscess drainage
- This code covers drainage involving the epididymis, testis, or scrotal space. Code 55100 is for an abscess limited to the scrotal wall.
- 55110Scrotal exploration
- Code 55110 describes scrotal exploration. Choose 54700 when the operative service includes drainage of an abscess at the epididymis, testis, or scrotal space.
- 54800Epididymal biopsy
- Code 54800 is for epididymal biopsy, a diagnostic tissue-sampling service. Use 54700 for operative drainage of an abscess involving the epididymis or another named site.
54700 billing questions
How does this differ from drainage of a scrotal wall abscess?
Use this code when the abscess involves the epididymis, testis, or scrotal space. A collection confined to the scrotal wall is represented by 55100.
What documentation supports reporting this code?
The operative note should identify the drained site, laterality, and findings showing an abscess involving the epididymis, testis, or scrotal space.
How is bilateral drainage reported?
Report modifier 50 for a bilateral procedure; CMS pays this code at 150% when reported bilaterally.
Are postoperative visits separately payable during the global period?
Related postoperative visits for 10 days are included in the minor-procedure global period.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
CMS does not pay an assistant at surgery for this code, and 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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