CPT code 55600: Vesiculotomy2026 Medicare rate & RVUs in Illinois
An uncomplicated operative incision into a seminal vesicle, reported when the surgeon treats the gland without documenting a complicated vesiculotomy.
CMS doesn’t publish an office rate for 55600 in Illinois.
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 55600 covers
Vesiculotomy is an operative incision into a seminal vesicle, a gland behind the bladder that contributes fluid to semen. A urologist performs the procedure to access or treat a seminal-vesicle problem while leaving the gland in place, rather than removing it. This uncommon male genitourinary operation is generally performed in an operating room. The operative report should identify the indication, the treated side, and the work performed.
Report 55600 when the documentation supports an uncomplicated vesiculotomy; use 55605 when the operation is documented as complicated. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For procedures performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery is paid only when medical necessity is documented; 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.
Where 55600 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $430.11 |
| East St. Louis | Unavailable | $409.01 |
| Rest Of Illinois | Unavailable | $394.83 |
| Suburban Chicago | Unavailable | $417.65 |
How the 55600 rate is calculated
Each of 55600’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 · 55600
RVUs × geographic indexes × conversion factor
Work6.83
6.83 RVUs× 1.000 GPCI
Practice expense3.96
3.96 RVUs× 1.000 GPCI
Malpractice0.88
0.88 RVUs× 1.000 GPCI
Adjusted RVUs
11.6700
Conversion factor
$33.4009
Medicare rate
$389.79
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 55600
55600 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 55600
Vesiculotomy
| 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) | 0 | Not paid without supporting documentation. |
| 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 · 55600
Vesiculotomy
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
55600 without 50 · national facility
$389.79
Vesiculotomy
55600-50 · Bilateral: 150%
$584.69
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).
55600 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 55605Vesiculotomy
- Both codes describe vesiculotomy. Choose 55600 for the uncomplicated service and 55605 when the operative service is documented as complicated.
- 55650Vesiculectomy
- 55600 involves an incision into the seminal vesicle; 55650 represents removal of the seminal vesicle.
- 55680Seminal vesicle surgery
- 55600 describes vesiculotomy, while 55680 is used for excision of a lesion of the seminal vesicle.
55600 billing questions
How is 55600 distinguished from 55605?
Use 55600 for a vesiculotomy documented as uncomplicated. Use 55605 when the operative service is documented as complicated.
Does 55600 include removal of the seminal vesicle?
No. Vesiculotomy describes an incision that leaves the gland in place; removal is represented by a different procedure code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is a bilateral procedure reported?
For a bilateral vesiculotomy, report modifier 50; Medicare pays the procedure at 150%.
Can an assistant or another surgeon be reported?
Assistant-at-surgery payment is allowed only with documentation of medical necessity. 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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