No office rate
Both codes address scrotal reconstruction. Choose 55175 for a simple revision and 55180 when the documented reconstruction is complicated.
On this page
CMS RVU26D · Effective 2026-10-01
55175 Scrotal revision Medicare reimbursement rates in Hawaii
Reports a simple surgical reshaping or revision of scrotal tissue, such as correction of scrotal webbing, rather than drainage or lesion removal. Compare 55175 office and facility rates across CMS payment localities in Hawaii.
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 55175 in Hawaii?
Hawaii 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
$346.07
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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.
Urologic surgery
About 55175: Simple scrotal revision
Reports a simple surgical reshaping or revision of scrotal tissue, such as correction of scrotal webbing, rather than drainage or lesion removal.
A simple scrotal revision reshapes scrotal skin or tissue to correct a contour problem, such as penoscrotal webbing. A urologist or plastic surgeon typically performs the procedure in an operating room or other surgical setting. The work is reconstructive; drainage of an abscess, exploration of the scrotum, and removal of a discrete lesion describe different services.
Select this code when the operative report supports a simple revision rather than the more complicated scrotal reconstruction represented by 55180. Document the reason for surgery, the tissue revised, and the operative steps. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this scrotal procedure. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 55175
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.72 · 56%
- Practice expense (office) RVU3.70 · 36%
- Malpractice RVU0.75 · 7%
419
Medicare services in 2024 · #3697 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.
55175 compared with similar codes
Office rates for Hawaii, from the same CMS release.
$264.15
55100 describes drainage of a scrotal abscess; 55175 is for reshaping or revising scrotal tissue.
No office rate
55120 is for removal of a scrotal lesion. Use 55175 when the operative objective is scrotal revision rather than excision of a discrete lesion.
Compare 55175 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$346.07
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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 55175 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
6,344
- Code
- 55175
- Physician work
- 5.72
- Practice expense
- 3.70
- Malpractice
- 0.75
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.72 | × 1.000 | 5.7200 |
| Practice expense | 3.70 | × 1.137 | 4.2069 |
| Malpractice | 0.75 | × 0.579 | 0.4342 |
| Total RVUs | 10.3612 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$346.07
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.72 | 1 |
| Practice expense | 3.7 | 1.137 |
| Malpractice | 0.75 | 0.579 |
(5.72 × 1 + 3.7 × 1.137 + 0.75 × 0.579) × $33.4009 = $346.07
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.
55175 billing questions
How does 55175 differ from 55180?
55175 is for a simple scrotal revision. Use 55180 when the documented reconstruction is complicated; the operative report should support the level selected.
Can 55175 be reported for scrotal abscess drainage or lesion removal?
No. Abscess drainage and removal of a discrete scrotal lesion are different services; 55175 describes revision of scrotal tissue.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
When is assistant-at-surgery payment allowed?
Only when medical necessity for the assistant is documented. 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.
6,34155110,,Explore scrotum,A,,6.17,3.84,NA,3.84,,0.86,10.87,10.87,0,090,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,34255120,,Removal of scrotum lesion,A,,5.58,3.63,NA,3.63,,0.71,9.92,9.92,0,090,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,34355150,,Removal of scrotum,A,,7.94,4.62,NA,4.62,,1.08,13.64,13.64,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,34455175,,Revision of scrotum,A,,5.72,3.70,NA,3.70,,0.75,10.17,10.17,0,090,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,34555180,,Revision of scrotum,A,,11.49,5.69,NA,5.69,,1.50,18.68,18.68,0,090,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,34655200,,Incision of sperm duct,A,,4.44,6.83,,2.73,,0.56,11.83,7.73,0,090,0.10,0.80,0.10,2,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,34755250,,Removal of sperm duct(s),A,,3.29,6.67,,2.82,,0.42,10.38,6.53,0,090,0.10,0.80,0.10,2,2,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014