CPT code 55870: Electroejaculation2026 Medicare rate & RVUs in Rhode Island
A urologist uses electrical stimulation to induce ejaculation and collect semen, commonly when neurologic injury or dysfunction prevents ejaculation.
Medicare pays $188.76 for 55870 in the office in Rhode Island (Rhode Island). 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 55870 covers
A urologist performs electroejaculation by applying controlled electrical stimulation with a rectal probe to induce ejaculation and collect a semen specimen. It is commonly used for fertility evaluation or assisted reproduction when a patient cannot ejaculate voluntarily, including some men with spinal cord injury or other neurologic dysfunction. The procedure may be performed with anesthesia or other support appropriate to the patient and setting.
Report 55870 for the electroejaculation procedure, not for semen analysis or laboratory sperm processing alone. Documentation should identify the reason ejaculation cannot be achieved by usual means, the procedure performed, and the specimen collected. The 0-day global period includes same-day preoperative and postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted; co-surgeons require supporting documentation, and team surgery is 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.
55870 in Rhode Island
| Payment locality | Office | Facility |
|---|---|---|
| Rhode Island | $188.76 | $129.07 |
How the 55870 rate is calculated
Each of 55870’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 · 55870
RVUs × geographic indexes × conversion factor
Work2.52
2.52 RVUs× 1.000 GPCI
Practice expense2.70
2.70 RVUs× 1.000 GPCI
Malpractice0.33
0.33 RVUs× 1.000 GPCI
Adjusted RVUs
5.5500
Conversion factor
$33.4009
Medicare rate
$185.37
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 55870
The CMS indicators that decide how 55870 is paid alongside other services.
CMS payment indicators · 55870
Electroejaculation
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
55870 without 51 · national office
$185.37
Electroejaculation
55870-51 · Second procedure: 50%
$92.69
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
55870 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 89320Semen anal vol/count/mot
- 55870 is the procedure to induce ejaculation and obtain a specimen; 89320 describes complete laboratory semen analysis.
- 89321Semen anal sperm detection
- Use 89321 for laboratory assessment of sperm presence or motility, not for electrically induced ejaculation and specimen collection.
- 89264Identify sperm tissue
- 89264 concerns sperm identification from testicular or epididymal material. 55870 obtains semen by electrically inducing ejaculation.
55870 billing questions
When is 55870 appropriate instead of a semen analysis code?
Use 55870 for the procedure that electrically induces ejaculation and collects semen. A semen analysis code describes laboratory examination of a specimen, not the retrieval procedure.
Can semen analysis or sperm processing be reported separately?
A laboratory service such as semen analysis or sperm isolation is distinct from electroejaculation when it is actually performed and documented. Report the applicable laboratory service rather than treating it as part of the retrieval procedure.
Does modifier 50 apply if stimulation is performed bilaterally?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
What same-day care is included in the global period?
The 0-day global period includes same-day preoperative and postoperative care. It does not extend the global period beyond the day of the procedure.
How is 55870 affected when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are subject to the reduction. Assistant-at-surgery payment is restricted, co-surgeons require supporting documentation, and team surgery is 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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