No office rate
55530 is for varicocele excision or spermatic-vein ligation without the combined hernia repair. This code represents the hernia-and-vein service.
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CMS RVU26D · Effective 2026-10-01
55540 Hernia and varicocele surgery Medicare reimbursement rates in Texas
Reports an inguinal hernia operation combined with treatment of spermatic veins, such as for a varicocele, during the same surgical service. Compare 55540 office and facility rates across CMS payment localities in Texas.
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 55540 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
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.
Where 55540 pays more and less in Texas
Urologic surgery
About 55540: Inguinal hernia repair with spermatic vein treatment
Reports an inguinal hernia operation combined with treatment of spermatic veins, such as for a varicocele, during the same surgical service.
This code represents an operation that addresses an inguinal hernia and spermatic veins in the same surgical service. The vein treatment may involve excision or ligation for a varicocele. Urologists and surgeons typically perform the procedure in an operating room, with the operative report identifying the hernia repair and the spermatic-vein work performed.
Select the code when the documented service includes both parts of the combined procedure; a varicocele operation without hernia repair is a different service. The report should support the treated side, the hernia work, and the spermatic-vein treatment. Medicare assigns a 90-day global period, including 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%. A bilateral procedure reported with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 55540
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.09 · 50%
- Practice expense (office) RVU5.92 · 37%
- Malpractice RVU2.16 · 13%
28
Medicare services in 2024 · #5712 by national volume
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.
55540 compared with similar codes
Office rates for Texas, from the same CMS release.
No office rate
Both involve hernia and spermatic-vein work. Check the full descriptors and operative report to distinguish the service represented by 55535 from this code.
No office rate
55550 describes laparoscopic spermatic-vein ligation for varicocele; it is not the combined hernia-and-vein service represented here.
No office rate
49505 is an inguinal hernia repair code without the spermatic-vein treatment that characterizes this combined service.
Compare 55540 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office Unavailable | Facility $543.88 |
| Beaumont | Office Unavailable | Facility $517.17 |
| Brazoria | Office Unavailable | Facility $524.60 |
| Dallas | Office Unavailable | Facility $531.49 |
| Fort Worth | Office Unavailable | Facility $530.45 |
| Galveston | Office Unavailable | Facility $528.46 |
| Houston | Office Unavailable | Facility $568.00 |
| Rest Of Texas | Office Unavailable | Facility $523.01 |
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55540 billing questions
How does this differ from 55530?
55530 describes varicocele excision or spermatic-vein ligation without the hernia repair included in this combined service. Use the code supported by the operative work performed.
Should the varicocele procedure also be reported separately?
The combined service includes treatment of the spermatic veins with the hernia operation. Do not separately report a code for that same vein work.
How does 55535 differ from this code?
Both codes involve hernia and spermatic-vein work. Compare the full code descriptors with the operative report to determine whether the documented service matches 55535's varicocele-focused wording or this code's hernia-and-vein service.
What documentation supports reporting this code?
The operative report should describe both the inguinal hernia repair and the spermatic-vein procedure, including the treated side and the work performed.
How are bilateral services handled?
When the procedure is bilateral and reported with modifier 50, CMS pays it at 150%.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeon payment is allowed only with supporting documentation.
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.
6,35155520,,Removal of sperm cord lesion,A,,6.49,5.33,NA,5.33,,1.64,13.46,13.46,0,090,0.10,0.80,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,35255530,,Revise spermatic cord veins,A,,5.61,3.44,NA,3.44,,0.73,9.78,9.78,0,090,0.10,0.80,0.10,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,35355535,,Revise spermatic cord veins,A,,7.01,3.99,NA,3.99,,0.91,11.91,11.91,0,090,0.10,0.80,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,35455540,,Revise hernia & sperm veins,A,,8.09,5.92,NA,5.92,,2.16,16.17,16.17,0,090,0.10,0.80,0.10,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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