Billing code 55100: Scrotal abscess drainageMedicare rate & RVUs in Missouri
Drainage of a scrotal abscess is reported when the clinician opens and evacuates an abscess arising in scrotal tissue.
Medicare pays $226.36–$240.72 for 55100 in the office in Missouri, from Rest Of Missouri to Metropolitan St. Louis. Which amount applies depends on the service address.
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 55100 covers
This service treats a localized collection of infected material in the scrotum by opening the abscess and allowing it to drain. It is commonly performed by a urologist or other surgeon in an office, emergency, or operating-room setting, depending on the patient’s condition and the extent of infection. The target is scrotal tissue; an abscess centered in the epididymis or another deeper structure calls for a site-specific procedure.
Select 55100 based on the abscess location and the drainage performed, not merely scrotal swelling, cellulitis, or exploration. Document the site, findings, and procedure performed. CMS assigns a 10-day minor-procedure global period, so related postoperative visits during that period are included. When another procedure is performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; 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 55100 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$226.36 to $240.72
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City | $238.38 | $159.35 |
| Metropolitan St. Louis | $240.72 | $160.59 |
| Rest Of Missouri | $226.36 | $153.80 |
How the 55100 rate is calculated
Each of 55100’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 · 55100
RVUs × geographic indexes × conversion factor
Work2.39
2.39 RVUs× 1.000 GPCI
Practice expense4.66
4.66 RVUs× 1.000 GPCI
Malpractice0.38
0.38 RVUs× 1.000 GPCI
Adjusted RVUs
7.4300
Conversion factor
$33.4009
Medicare rate
$248.17
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 55100
55100 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 55100
Scrotal abscess drainage
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| 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 · 55100
Scrotal abscess drainage
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
55100 without 51 · national office
$248.17
Scrotal abscess drainage
55100-51 · Second procedure: 50%
$124.09
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
55100 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 10060Abscess drainage
- 10060 is the general code for drainage of a simple or single abscess. Use 55100 for drainage when the abscess is in scrotal tissue.
- 10061Abscess drainage
- 10061 describes drainage of complicated or multiple abscesses under the general abscess codes. 55100 identifies the scrotal site.
- 54700Genital abscess drainage
- 54700 is directed to an abscess of the epididymis. Use 55100 when the drained abscess is in scrotal tissue.
- 55110Scrotal exploration
- 55110 is scrotal exploration. It is not the drainage service represented by 55100 when a scrotal abscess is opened and drained.
55100 billing questions
When is 55100 preferred over 10060?
Use 55100 when the procedure drains an abscess in scrotal tissue. Code 10060 describes drainage of a simple or single abscess when the general abscess code fits the service.
What code applies to an abscess centered in the epididymis?
55100 is for an abscess of the scrotum. An abscess centered in the epididymis is a different anatomic target; compare 54700.
Can modifier 50 be reported for bilateral scrotal abscess drainage?
No. CMS identifies bilateral adjustment as inappropriate for 55100, so do not append modifier 50.
Are related postoperative visits separately reported during the global period?
Related postoperative visits during the 10-day global period are included in 55100.
How is 55100 paid when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. Medicare does not pay an assistant at surgery for 55100.
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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