Billing code 54535: Radical orchiectomyMedicare rate & RVUs in Texas
Reports radical removal of a testis for tumor through an abdominal approach, including situations in which the affected testis is located intra-abdominally.
CMS doesn’t publish an office rate for 54535 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 54535 covers
A urologist performs this operation to remove a testis for a tumor through an abdominal approach, with dissection of the associated spermatic cord. It may be used when the affected testis is intra-abdominal. The operation is performed in an operating room and is more extensive than removing a localized testicular lesion or only part of the testis.
Choose this code based on the operative indication, the radical extent of removal, and the abdominal route documented in the operative report. The code has a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; 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 54535 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 | $679.24 |
| Beaumont | Unavailable | $652.77 |
| Brazoria | Unavailable | $663.31 |
| Dallas | Unavailable | $668.98 |
| Fort Worth | Unavailable | $667.81 |
| Galveston | Unavailable | $666.33 |
| Houston | Unavailable | $696.53 |
| Rest Of Texas | Unavailable | $658.71 |
How the 54535 rate is calculated
Each of 54535’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 · 54535
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 12.86Practice expense 5.66Malpractice 1.65
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 54535
54535 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 54535
Radical 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) | 0 | Not permitted. |
| 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 · 54535
Radical 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
54535 without 50 · national facility
$673.70
Radical orchiectomy
54535-50 · Bilateral: 150%
$1,010.55
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).
54535 compared with similar codes
Compare codes
54535 vs 54530 vs 54520 vs 54522 vs 54512: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 54530Orchiectomy
- Use 54535 for the abdominal approach to radical tumor removal. Use 54530 when the radical operation is performed through the inguinal approach.
- 54520Testis removal
- This code describes radical tumor surgery by an abdominal approach; 54520 describes simple orchiectomy, not radical removal for tumor.
- 54522Partial orchiectomy
- Use 54522 when only part of the testis is removed. Use 54535 when the operation is radical removal for tumor through the abdominal approach.
- 54512Testicular surgery
- 54512 is for excision of a testicular lesion. Choose 54535 when the documented operation is radical removal for tumor through an abdominal approach.
54535 billing questions
How is this different from 54530?
Both describe radical removal for a testicular tumor. This code is for the abdominal approach; 54530 is for the inguinal approach.
When would a limited testicular excision be a better fit?
Use a limited excision code when the operation removes a localized lesion rather than the testis radically. The operative report should establish the extent of tissue removed.
What does the 90-day global period include?
It includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral surgery reported?
CMS lists bilateral reporting with modifier 50, paid at 150%.
Can an assistant or another surgeon be reported?
An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted for this code.
What should the operative report support?
Document the tumor indication, abdominal approach, and radical extent of removal, including the side operated on.
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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