No office rate
54550 is directed at an undescended testis. Use 54560 for a different testicular exploration indication, according to the operative work documented.
On this page
CMS RVU26D · Effective 2026-10-01
54550 Testis exploration Medicare reimbursement rates in New Jersey
Surgical exploration to locate and assess an undescended testis, typically performed by a urologist when examination has not established its position. Compare 54550 office and facility rates across CMS payment localities in New Jersey.
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 54550 in New Jersey?
New Jersey 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
$479.06–$493.98
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 54550: Exploration for undescended testis
Surgical exploration to locate and assess an undescended testis, typically performed by a urologist when examination has not established its position.
This operation involves surgically examining the inguinal or scrotal area to locate and assess a testis that has not descended. A urologist commonly performs it in a hospital or ambulatory surgery setting, often for a child with a nonpalpable or abnormally positioned testis. The exploration may establish the testis’s location and condition; relocation or removal is a distinct therapeutic step when performed.
Report 54550 when the operative service is exploration for an undescended testis, rather than a testicular biopsy, orchiopexy, or orchiectomy. The operative note should identify the indication, approach, findings, and any additional procedure performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For same-session procedures, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 54550
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.20 · 61%
- Practice expense (office) RVU4.25 · 31%
- Malpractice RVU1.07 · 8%
17
Medicare services in 2024 · #6011 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.
54550 compared with similar codes
Office rates for New Jersey, from the same CMS release.
No office rate
54550 represents exploration to locate and assess an undescended testis; 54640 represents operative fixation of a testis in position.
No office rate
54500 is for needle biopsy to obtain testicular tissue. Choose 54550 when the operation is exploration for an undescended testis.
No office rate
54505 is for incisional testicular biopsy. Exploration for an undescended testis is the distinct purpose of 54550.
Compare 54550 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
Northern Nj →
Office / nonfacility
Unavailable
Facility
$493.98
Rest Of New Jersey →
Office / nonfacility
Unavailable
Facility
$479.06
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54550 billing questions
When should 54550 be chosen over 54560?
Use 54550 for exploration directed at an undescended testis. Code 54560 describes a different testicular exploration; select based on the documented indication and procedure.
Is orchiopexy separately reported when the testis is found?
If the surgeon fixes the testis in position, report the applicable orchiopexy service for that therapeutic work. Do not automatically report the localization portion as a separate exploration.
What documentation supports 54550?
Document why exploration was needed, the surgical approach, the location and condition of the testis, and whether a separate therapeutic procedure was performed.
How is bilateral exploration reported?
CMS identifies 54550 as a bilateral procedure; reporting modifier 50 results in payment at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be paid for this procedure?
CMS permits payment for an assistant at surgery. 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.
6,31254522,,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
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