No office rate
Choose 54640 for an inguinal or scrotal approach. Choose 54650 when an abdominal approach is used, including for a Fowler-Stephens procedure.
On this page
CMS RVU26D · Effective 2026-10-01
54640 Orchiopexy Medicare reimbursement rates in Maine
Reports open repositioning and fixation of an undescended testis through an inguinal or scrotal approach, commonly performed for cryptorchidism. Compare 54640 office and facility rates across CMS payment localities in Maine.
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 54640 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$371.99–$379.89
2 of 2 localities have a supported rate.
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.
Urology surgery
About 54640: Open orchiopexy for undescended testis
Reports open repositioning and fixation of an undescended testis through an inguinal or scrotal approach, commonly performed for cryptorchidism.
A urologist, often a pediatric urologist, uses an inguinal or scrotal approach to mobilize an undescended testis and secure it in the scrotum. The operation is commonly performed for cryptorchidism in a hospital or ambulatory surgery setting. The operative report should identify the testis location, approach, side, and the work performed to bring the testis into the scrotum and fix it there.
Report this code for the inguinal or scrotal approach; an abdominal or laparoscopic approach has a different code. For bilateral surgery, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 54640
- 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 procedure with modifier 50 is paid at 150%.
- 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 RVU7.54 · 64%
- Practice expense (office) RVU3.20 · 27%
- Malpractice RVU1.05 · 9%
224
Medicare services in 2024 · #4220 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.
54640 compared with similar codes
Office rates for Maine, from the same CMS release.
No office rate
54692 identifies laparoscopic orchiopexy; 54640 identifies an inguinal or scrotal approach.
54620
No office rateTesticular suspension
54620 is fixation of a non-cryptorchid testis. 54640 is for bringing an undescended testis into the scrotum and fixing it there.
Compare 54640 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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
Unavailable
Facility
$371.99
Southern Maine →
Office / nonfacility
Unavailable
Facility
$379.89
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54640 billing questions
When should 54640 be selected instead of 54650?
Use 54640 for an inguinal or scrotal approach to an undescended testis. Code 54650 describes an abdominal approach, including the Fowler-Stephens method.
How does 54640 differ from laparoscopic orchiopexy?
54640 is for an inguinal or scrotal approach. Laparoscopic orchiopexy is reported with 54692.
How is bilateral orchiopexy reported under the CMS rule?
Report bilateral surgery with modifier 50. CMS pays the bilateral procedure at 150%.
What documentation supports reporting 54640?
The operative report should establish that the testis was undescended and document its location, the inguinal or scrotal approach, the side or sides treated, and the repositioning and fixation performed.
Does the 90-day global period include postoperative care?
Yes. It includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted under the listed CMS rules.
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.
6,31654560,,Exploration for testis,A,,11.80,5.36,NA,5.36,,1.50,18.66,18.66,0,090,0.10,0.80,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,31754600,,Reduce testis torsion,A,,7.45,4.08,NA,4.08,,0.96,12.49,12.49,0,090,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,31854620,,Suspension of testis,A,,5.08,2.43,NA,2.43,,0.65,8.16,8.16,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,31954640,,Orchiopexy ingun/scrot appr,A,,7.54,3.20,NA,3.20,,1.05,11.79,11.79,0,090,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,32054650,,Orchiopexy (fowler-stephens),A,,12.08,5.78,NA,5.78,,1.54,19.40,19.40,0,090,0.10,0.80,0.10,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,32154660,,Revision of testis,A,,5.60,3.70,NA,3.70,,0.71,10.01,10.01,0,090,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,32254670,,Repair testis injury,A,,6.48,4.02,NA,4.02,,0.84,11.34,11.34,0,090,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00