No office rate
54512 describes excision of a testicular lesion; 54522 is appropriate when the surgeon performs a partial orchiectomy, removing a portion of the testis.
On this page
CMS RVU26D · Effective 2026-10-01
54522 Partial orchiectomy Medicare reimbursement rates in Missouri
A urologist removes a localized portion of testicular tissue while preserving the remaining testis, typically for a selected focal mass requiring surgical treatment. Compare 54522 office and facility rates across CMS payment localities in Missouri.
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 54522 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$512.11–$527.57
3 of 3 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.
Where 54522 pays more and less in Missouri
Urologic surgery
About 54522: Partial testis removal with tissue preservation
A urologist removes a localized portion of testicular tissue while preserving the remaining testis, typically for a selected focal mass requiring surgical treatment.
A urologist removes a localized portion of testicular tissue and preserves the remainder of the testis. This approach may be selected for a small intratesticular mass when testis-sparing surgery is appropriate, including cases where retaining testicular tissue is clinically important. The operation is generally performed in an operating room; the removed tissue is evaluated to guide care and establish the diagnosis.
Report this code when the operation removes part of the testis, rather than only sampling tissue or removing the entire testis. The operative report should identify the side, the extent of tissue removed, and the tissue-preserving intent. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral reporting with modifier 50, CMS pays 150%. In the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 54522
- 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 may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.99 · 62%
- Practice expense (office) RVU4.74 · 30%
- Malpractice RVU1.29 · 8%
24
Medicare services in 2024 · #5820 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.
54522 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
54520 is for removal of the testis. Use 54522 when testicular tissue is removed but the remainder of the testis is preserved.
No office rate
54530 describes radical orchiectomy through an inguinal approach, with removal of the whole testis; 54522 is the tissue-preserving partial operation.
Compare 54522 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$524.43
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$527.57
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$512.11
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
54522 billing questions
When should this be reported instead of a testicular biopsy?
Report 54522 when the surgeon removes a portion of the testis as treatment, rather than taking tissue samples for diagnosis. The operative report should support the extent of the resection.
How does this differ from excision of a testicular lesion?
Choose 54522 when the procedure is a partial orchiectomy involving removal of part of the testis. Choose 54512 when the documented operation is excision of a lesion and does not constitute partial orchiectomy.
How is bilateral partial orchiectomy reported?
Use modifier 50 for bilateral reporting. CMS pays the bilateral procedure at 150%.
Are related postoperative visits included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
CMS may pay for an assistant at surgery. Co-surgeon payment requires supporting documentation; team surgery is 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.
6,30954505,,Biopsy of testis,A,,3.41,1.94,NA,1.94,,0.43,5.78,5.78,0,010,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,31054512,,Excise lesion testis,A,,9.10,4.39,NA,4.39,,1.19,14.68,14.68,0,090,0.10,0.80,0.10,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,31154520,,Removal of testis,A,,5.17,3.25,NA,3.25,,0.73,9.15,9.15,0,090,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,31254522,,Orchiectomy partial,A,,9.99,4.74,NA,4.74,,1.29,16.02,16.02,0,090,0.10,0.80,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,31354530,,Removal of testis,A,,8.25,4.69,NA,4.69,,1.11,14.05,14.05,0,090,0.10,0.80,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,31454535,,Extensive testis surgery,A,,12.86,5.66,NA,5.66,,1.65,20.17,20.17,0,090,0.10,0.80,0.10,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,31554550,,Exploration for testis,A,,8.20,4.25,NA,4.25,,1.07,13.52,13.52,0,090,0.10,0.80,0.10,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00