No office rate
Use 55680 for excision of a lesion involving the seminal vesicle. Use 55650 when the operation removes the seminal vesicle itself.
On this page
CMS RVU26D · Effective 2026-10-01
55680 Seminal vesicle surgery Medicare reimbursement rates in New Mexico
Removal of a lesion involving a seminal vesicle, reported when the surgeon excises the lesion rather than opening the vesicle or removing it entirely. Compare 55680 office and facility rates across CMS payment localities in New Mexico.
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 55680 in New Mexico?
New Mexico 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
No supported rate
Facility setting
$317.23
1 of 1 localities have a supported rate.
Payment area: New Mexico
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.
Urology surgery
About 55680: Seminal vesicle lesion excision
Removal of a lesion involving a seminal vesicle, reported when the surgeon excises the lesion rather than opening the vesicle or removing it entirely.
A urologic surgeon uses this code for excision of a lesion involving a seminal vesicle, a gland behind the bladder that contributes fluid to semen. A seminal vesicle cyst or other localized mass may prompt this operation. The service targets the lesion, rather than removal of the entire seminal vesicle as described by a different code. The surgeon may perform the procedure through an appropriate surgical approach based on the patient’s anatomy and the lesion.
Select the code when the operative report documents the seminal vesicle lesion and its excision; document the side and extent when relevant. This major surgery has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 55680
- 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 RVU5.53 · 57%
- Practice expense (office) RVU3.41 · 35%
- Malpractice RVU0.70 · 7%
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.
55680 compared with similar codes
Office rates for New Mexico, from the same CMS release.
No office rate
55600 describes vesiculotomy, an operation that opens the seminal vesicle. 55680 is for excision of a lesion involving the vesicle.
No office rate
55605 is the complicated vesiculotomy code. It describes opening the seminal vesicle, while 55680 describes excising a lesion.
Compare 55680 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
New Mexico →
Office / nonfacility
Unavailable
Facility
$317.23
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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 55680 in New Mexico.
PPRRVU2026_Oct_nonQPP.csv
6,360
- Code
- 55680
- Physician work
- 5.53
- Practice expense
- 3.41
- Malpractice
- 0.70
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.53 | × 1.000 | 5.5300 |
| Practice expense | 3.41 | × 0.917 | 3.1270 |
| Malpractice | 0.70 | × 1.201 | 0.8407 |
| Total RVUs | 9.4977 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, New Mexico$317.23
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.53 | 1 |
| Practice expense | 3.41 | 0.917 |
| Malpractice | 0.7 | 1.201 |
(5.53 × 1 + 3.41 × 0.917 + 0.7 × 1.201) × $33.4009 = $317.23
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.
55680 billing questions
How does this differ from 55650?
55680 is for excision of a lesion involving the seminal vesicle. 55650 describes excision of the seminal vesicle itself, so use the code that matches the operative extent.
When would 55600 or 55605 be more appropriate?
Those codes describe vesiculotomy, or opening the seminal vesicle. Choose 55680 when the operative service is excision of a lesion rather than vesicle incision.
What documentation supports 55680?
The operative report should identify the seminal vesicle lesion and describe its excision. Include laterality and the extent of the procedure when documented.
How is bilateral surgery reported?
For a bilateral procedure, report modifier 50; CMS pays the bilateral service 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 or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code under the supplied 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.
6,35755600,,Vesiculotomy,A,,6.83,3.96,NA,3.96,,0.88,11.67,11.67,0,090,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,35855605,,Vesiculotomy complicated,A,,8.54,4.79,NA,4.79,,1.10,14.43,14.43,0,090,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,35955650,,Remove sperm duct pouch,A,,12.33,5.59,NA,5.59,,1.59,19.51,19.51,0,090,0.10,0.80,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,36055680,,Remove sperm pouch lesion,A,,5.53,3.41,NA,3.41,,0.70,9.64,9.64,0,090,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,36155705,,Bx prst8 any approach nonimg,A,,1.88,4.87,,0.88,,0.23,6.98,2.99,0,000,0.00,0.00,0.00,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,36255706,,Bx prst8 ndl sat sampling,A,,4.16,1.40,NA,1.40,,0.53,6.09,6.09,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,36355707,,Bx prst8 trct us guided,A,,2.63,7.26,,1.10,,0.35,10.24,4.08,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068
7612402,NJ,99,REST OF NEW JERSEY,1.040,1.092,1.097
7704212,NM,05,NEW MEXICO,1.000,0.917,1.201
7813202,NY,01,MANHATTAN,1.064,1.162,1.586
7913202,NY,02,NYC SUBURBS/LONG ISLAND,1.064,1.189,1.857
8013202,NY,03,POUGHKPSIE/N NYC SUBURBS,1.045,1.095,1.210