No office rate
Use 55600 for a simple vesiculotomy. Use 55605 when the operative report supports the complicated level.
On this page
CMS RVU26D · Effective 2026-10-01
55605 Vesiculotomy Medicare reimbursement rates in Rhode Island
Reports a complicated operative incision into a seminal vesicle, such as for access to a cyst or obstructing pathology requiring more than a simple approach. Compare 55605 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 55605 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
$488.71
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.
Urology surgery
About 55605: Complicated seminal vesicle incision
Reports a complicated operative incision into a seminal vesicle, such as for access to a cyst or obstructing pathology requiring more than a simple approach.
A urologist performs an operative incision into a seminal vesicle to reach or treat pathology within it. A seminal-vesicle cyst or obstructing calculus may be an indication. This code represents the complicated level of the procedure, not removal of the seminal vesicle; the operative report should make the extent and nature of the work clear. The service is typically performed in an operating room.
Choose this code when the documented operation supports a complicated vesiculotomy rather than the simple level. Record the indication, operative approach, structures treated, and laterality. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral performance, 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%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 55605
- 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 RVU8.54 · 59%
- Practice expense (office) RVU4.79 · 33%
- Malpractice RVU1.10 · 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.
55605 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
55650 represents vesiculectomy, or removal of a seminal vesicle; 55605 represents an incision into the seminal vesicle.
No office rate
55680 is a vesiculectomy code for removal of seminal-vesicle tissue. Select 55605 when the service is an incision rather than excision.
Compare 55605 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
$488.71
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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 55605 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
6,358
- Code
- 55605
- Physician work
- 8.54
- Practice expense
- 4.79
- Malpractice
- 1.10
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.54 | × 1.019 | 8.7023 |
| Practice expense | 4.79 | × 1.033 | 4.9481 |
| Malpractice | 1.10 | × 0.892 | 0.9812 |
| Total RVUs | 14.6315 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$488.71
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.54 | 1.019 |
| Practice expense | 4.79 | 1.033 |
| Malpractice | 1.1 | 0.892 |
(8.54 × 1.019 + 4.79 × 1.033 + 1.1 × 0.892) × $33.4009 = $488.71
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.
55605 billing questions
How does this differ from 55600?
55600 is the simple vesiculotomy level. Report 55605 when the operative documentation supports a complicated procedure; the distinction should be evident from the work described.
Is this an incision or removal of the seminal vesicle?
It describes an incision into the seminal vesicle. Removal is represented by vesiculectomy codes such as 55650 or 55680, depending on the procedure performed.
What is included in the global period?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral performance reported?
When the procedure is performed bilaterally, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. 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.
6,35555550,,Laparo ligate spermatic vein,A,,7.02,3.95,NA,3.95,,0.91,11.88,11.88,0,090,0.10,0.80,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,35655559,,Unlstd laps px sprmatic cord,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
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
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