No office rate
54640 is for orchiopexy through an inguinal or scrotal approach. Select 54650 when the operative report documents Fowler-Stephens treatment of an abdominal testis.
On this page
CMS RVU26D · Effective 2026-10-01
54650 Orchiopexy Medicare reimbursement rates in Rhode Island
Reports surgical placement of an undescended abdominal testis using a Fowler-Stephens technique, typically when a high testis cannot reach the scrotum safely. Compare 54650 office and facility rates across CMS payment localities in Rhode Island.
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 54650 in Rhode Island?
Rhode Island 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
$656.46
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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.
Urologic surgery
About 54650: Fowler-Stephens abdominal orchiopexy
Reports surgical placement of an undescended abdominal testis using a Fowler-Stephens technique, typically when a high testis cannot reach the scrotum safely.
This operation treats a testis that remains within the abdomen and cannot be brought to the scrotum without addressing its blood supply. In the Fowler-Stephens technique, the surgeon divides the testicular vessels so collateral circulation can support the testis as it is moved into the scrotum. Pediatric urologists commonly perform the procedure for a high intra-abdominal undescended testis; it may be completed in stages depending on the operative plan and anatomy.
Report the code when the operative documentation supports Fowler-Stephens orchiopexy for an abdominal testis, including the side treated and whether the procedure was staged. The CMS global period includes the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery, 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%. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 54650
- 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 RVU12.08 · 62%
- Practice expense (office) RVU5.78 · 30%
- Malpractice RVU1.54 · 8%
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.
54650 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
54692 identifies laparoscopic orchiopexy. Distinguish it from 54650 by the documented procedure and approach, not simply by the testis being undescended.
54620
No office rateTesticular suspension
54620 describes testicular fixation, commonly in a different clinical context. It is not the code for Fowler-Stephens placement of an abdominal undescended testis.
Compare 54650 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
Rhode Island →
Office / nonfacility
Unavailable
Facility
$656.46
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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 54650 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
6,320
- Code
- 54650
- Physician work
- 12.08
- Practice expense
- 5.78
- Malpractice
- 1.54
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.08 | × 1.019 | 12.3095 |
| Practice expense | 5.78 | × 1.033 | 5.9707 |
| Malpractice | 1.54 | × 0.892 | 1.3737 |
| Total RVUs | 19.6539 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$656.46
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.08 | 1.019 |
| Practice expense | 5.78 | 1.033 |
| Malpractice | 1.54 | 0.892 |
(12.08 × 1.019 + 5.78 × 1.033 + 1.54 × 0.892) × $33.4009 = $656.46
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.
54650 billing questions
When should this code be selected instead of 54640?
Use 54650 for Fowler-Stephens orchiopexy of an abdominal testis. Code 54640 describes orchiopexy by an inguinal or scrotal approach.
How does this differ from laparoscopic orchiopexy code 54692?
Code 54692 identifies laparoscopic orchiopexy. Choose the code that matches the documented procedure and approach; an abdominal testis alone does not establish that the Fowler-Stephens code applies.
What operative details support reporting 54650?
Document the abdominal location of the undescended testis, the Fowler-Stephens technique, the side treated, and whether the repair was staged.
How is bilateral surgery reported?
For bilateral surgery, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant surgeon be reported?
CMS permits payment for an assistant at surgery. Co-surgeons and team surgery are not permitted for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
6,31754600,,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
6,31954640,,Orchiopexy ingun/scrot appr,A,,7.54,3.20,NA,3.20,,1.05,11.79,11.79,0,090,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,32054650,,Orchiopexy (fowler-stephens),A,,12.08,5.78,NA,5.78,,1.54,19.40,19.40,0,090,0.10,0.80,0.10,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,32154660,,Revision of testis,A,,5.60,3.70,NA,3.70,,0.71,10.01,10.01,0,090,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,32254670,,Repair testis injury,A,,6.48,4.02,NA,4.02,,0.84,11.34,11.34,0,090,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,32354680,,Relocation of testis(es),A,,13.69,5.86,NA,5.86,,1.76,21.31,21.31,0,090,0.10,0.80,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537