No office rate
Use 55000 for needle drainage; 55040 describes surgical removal of a hydrocele.
On this page
CMS RVU26D · Effective 2026-10-01
55000 Hydrocele drainage Medicare reimbursement rates in Kentucky
Reports needle drainage of fluid from a hydrocele around the testicle, with or without injection during the aspiration treatment. Compare 55000 office and facility rates across CMS payment localities in Kentucky.
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 55000 in Kentucky?
Kentucky 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
$117.55
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
Facility setting
$73.90
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 procedure
About 55000: Hydrocele aspiration and drainage
Reports needle drainage of fluid from a hydrocele around the testicle, with or without injection during the aspiration treatment.
A urologist typically performs this procedure by inserting a needle through the scrotal skin and removing fluid from the sac surrounding the testicle. An injection may be given as part of the same treatment. It is used to relieve fluid buildup without surgically removing the hydrocele sac, and is commonly performed in an office or outpatient setting. For example, a clinician may drain a symptomatic hydrocele that is causing scrotal enlargement or discomfort.
Choose this code for needle drainage, not surgical removal or repair of the hydrocele. The record should identify the treated side, the hydrocele, and the aspiration performed; document any injection given during the treatment. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral treatment, 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 for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 55000
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.39 · 37%
- Practice expense (office) RVU2.21 · 58%
- Malpractice RVU0.18 · 5%
4.4K
Medicare services in 2024 · #1962 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.
55000 compared with similar codes
Office rates for Kentucky, from the same CMS release.
Compare 55000 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
Kentucky →
Office / nonfacility
$117.55
Facility
$73.90
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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 55000 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
6,336
- Code
- 55000
- Physician work
- 1.39
- Practice expense
- 2.21
- Malpractice
- 0.18
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.39 | × 1.000 | 1.3900 |
| Practice expense | 2.21 | × 0.889 | 1.9647 |
| Malpractice | 0.18 | × 0.915 | 0.1647 |
| Total RVUs | 3.5194 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$117.55
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.39 | 1 |
| Practice expense | 2.21 | 0.889 |
| Malpractice | 0.18 | 0.915 |
(1.39 × 1 + 2.21 × 0.889 + 0.18 × 0.915) × $33.4009 = $117.55
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.39 | 1 |
| Practice expense | 0.74 | 0.889 |
| Malpractice | 0.18 | 0.915 |
(1.39 × 1 + 0.74 × 0.889 + 0.18 × 0.915) × $33.4009 = $73.90
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.
55000 billing questions
When should I report drainage rather than hydrocele removal?
Report 55000 when the clinician drains the fluid with a needle. Surgical removal of the hydrocele sac is a different service, represented by codes such as 55040 or 55041.
Can an injection be included with the aspiration?
Yes. The code includes treatment with or without an injection during the aspiration procedure; do not report the injection as a separate service solely for that part of the treatment.
How is bilateral drainage reported?
When both sides are treated, report the bilateral procedure with modifier 50. CMS pays the bilateral procedure at 150%.
What same-day care is included?
The 0-day global period includes same-day preoperative and postoperative care. A separate service requires support beyond the care included in the procedure.
Can an assistant or another surgeon be billed for this procedure?
Medicare does not pay an assistant at surgery for 55000. 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.
6,33354865,,Explore epididymis,A,,5.63,3.71,NA,3.71,,0.72,10.06,10.06,0,090,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,33454900,,Fusion of spermatic ducts,A,,13.85,6.08,NA,6.08,,1.77,21.70,21.70,0,090,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,33554901,,Fusion of spermatic ducts,A,,18.62,7.46,NA,7.46,,2.40,28.48,28.48,0,090,0.10,0.80,0.10,2,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,33655000,,Drainage of hydrocele,A,,1.39,2.21,,0.74,,0.18,3.78,2.31,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,33755040,,Removal of hydrocele,A,,5.31,3.41,NA,3.41,,0.71,9.43,9.43,0,090,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,33855041,,Removal of hydroceles,A,,8.33,4.67,NA,4.67,,1.10,14.10,14.10,0,090,0.10,0.80,0.10,2,2,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,33955060,,Repair of hydrocele,A,,6.00,3.81,NA,3.81,,0.79,10.60,10.60,0,090,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631