Billing code 54522: Partial orchiectomyMedicare rate & RVUs in Texas
A urologist removes a localized portion of testicular tissue while preserving the remaining testis, typically for a selected focal mass requiring surgical treatment.
CMS doesn’t publish an office rate for 54522 in Texas.
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 54522 covers
A urologist removes a localized portion of testicular tissue and preserves the remainder of the testis. This approach may be selected for a small intratesticular mass when testis-sparing surgery is appropriate, including cases where retaining testicular tissue is clinically important. The operation is generally performed in an operating room; the removed tissue is evaluated to guide care and establish the diagnosis.
Report this code when the operation removes part of the testis, rather than only sampling tissue or removing the entire testis. The operative report should identify the side, the extent of tissue removed, and the tissue-preserving intent. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral reporting with modifier 50, CMS pays 150%. In the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires 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.
Where 54522 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $540.02 |
| Beaumont | Unavailable | $517.77 |
| Brazoria | Unavailable | $526.85 |
| Dallas | Unavailable | $531.33 |
| Fort Worth | Unavailable | $530.31 |
| Galveston | Unavailable | $529.23 |
| Houston | Unavailable | $552.84 |
| Rest Of Texas | Unavailable | $522.83 |
How the 54522 rate is calculated
Each of 54522’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 · 54522
RVUs × geographic indexes × conversion factor
Work9.99
9.99 RVUs× 1.000 GPCI
Practice expense4.74
4.74 RVUs× 1.000 GPCI
Malpractice1.29
1.29 RVUs× 1.000 GPCI
Adjusted RVUs
16.0200
Conversion factor
$33.4009
Medicare rate
$535.08
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 54522
54522 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 54522
Partial orchiectomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 54522
Partial orchiectomy
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
54522 without 50 · national facility
$535.08
Partial orchiectomy
54522-50 · Bilateral: 150%
$802.62
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).
54522 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 54512Testicular surgery
- 54512 describes excision of a testicular lesion; 54522 is appropriate when the surgeon performs a partial orchiectomy, removing a portion of the testis.
- 54520Testis removal
- 54520 is for removal of the testis. Use 54522 when testicular tissue is removed but the remainder of the testis is preserved.
- 54530Orchiectomy
- 54530 describes radical orchiectomy through an inguinal approach, with removal of the whole testis; 54522 is the tissue-preserving partial operation.
54522 billing questions
When should this be reported instead of a testicular biopsy?
Report 54522 when the surgeon removes a portion of the testis as treatment, rather than taking tissue samples for diagnosis. The operative report should support the extent of the resection.
How does this differ from excision of a testicular lesion?
Choose 54522 when the procedure is a partial orchiectomy involving removal of part of the testis. Choose 54512 when the documented operation is excision of a lesion and does not constitute partial orchiectomy.
How is bilateral partial orchiectomy reported?
Use modifier 50 for bilateral reporting. CMS pays the bilateral procedure at 150%.
Are related postoperative visits included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
CMS may pay for an assistant at surgery. Co-surgeon payment requires supporting documentation; 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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