Billing code 55000: Hydrocele drainageMedicare rate & RVUs in Oregon
Reports needle drainage of fluid from a hydrocele around the testicle, with or without injection during the aspiration treatment.
Medicare pays $124.17–$133.65 for 55000 in the office in Oregon, from Rest Of Oregon to Portland. 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 55000 covers
A urologist typically performs this procedure by inserting a needle through the scrotal skin and removing fluid from the sac surrounding the testicle. An injection may be given as part of the same treatment. It is used to relieve fluid buildup without surgically removing the hydrocele sac, and is commonly performed in an office or outpatient setting. For example, a clinician may drain a symptomatic hydrocele that is causing scrotal enlargement or discomfort.
Choose this code for needle drainage, not surgical removal or repair of the hydrocele. The record should identify the treated side, the hydrocele, and the aspiration performed; document any injection given during the treatment. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral treatment, modifier 50 is paid at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. 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 55000 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $133.65 | $79.10 |
| Rest Of Oregon | $124.17 | $75.27 |
How the 55000 rate is calculated
Each of 55000’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 · 55000
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.39Practice expense 2.21Malpractice 0.18
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 55000
The CMS indicators that decide how 55000 is paid alongside other services.
CMS payment indicators · 55000
Hydrocele drainage
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
55000 without 50 · national office
$126.26
Hydrocele drainage
55000-50 · Bilateral: 150%
$189.39
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
55000 compared with similar codes
Compare codes
55000 vs 55040 vs 55041 vs 55060: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 55040Hydrocelectomy
- Use 55000 for needle drainage; 55040 describes surgical removal of a hydrocele.
- 55041Hydrocelectomy
- Use 55000 for needle drainage; 55041 describes surgical removal of hydroceles.
- 55060Hydrocele repair
- Use 55000 when the hydrocele is drained by aspiration; 55060 is for surgical repair.
55000 billing questions
When should I report drainage rather than hydrocele removal?
Report 55000 when the clinician drains the fluid with a needle. Surgical removal of the hydrocele sac is a different service, represented by codes such as 55040 or 55041.
Can an injection be included with the aspiration?
Yes. The code includes treatment with or without an injection during the aspiration procedure; do not report the injection as a separate service solely for that part of the treatment.
How is bilateral drainage reported?
When both sides are treated, report the bilateral procedure with modifier 50. CMS pays the bilateral procedure at 150%.
What same-day care is included?
The 0-day global period includes same-day preoperative and postoperative care. A separate service requires support beyond the care included in the procedure.
Can an assistant or another surgeon be billed for this procedure?
Medicare does not pay an assistant at surgery for 55000. 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 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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