No office rate
55175 describes simple scrotal revision. Use 55180 when the documented reconstruction is complicated, such as scrotal reduction or correction of penoscrotal webbing.
On this page
CMS RVU26D · Effective 2026-10-01
55180 Scrotoplasty Medicare reimbursement rates in Vermont
Reports complex reconstructive surgery to correct scrotal anatomy, such as scrotal reduction or correction of penoscrotal webbing. Compare 55180 office and facility rates across CMS payment localities in Vermont.
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 55180 in Vermont?
Vermont 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
$597.28
1 of 1 localities have a supported rate.
Payment area: Vermont
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.
Urologic surgery
About 55180: Complicated scrotal reconstruction
Reports complex reconstructive surgery to correct scrotal anatomy, such as scrotal reduction or correction of penoscrotal webbing.
This code describes a more involved reconstruction of the scrotum than a simple revision. A urologist or plastic surgeon may use it to correct substantial scrotal skin or contour problems, including scrotal excess or penoscrotal webbing. These procedures are generally performed in a surgical facility and may address a congenital deformity or a change resulting from prior surgery or injury.
Choose this level based on the reconstructive work documented, distinguishing it from a simple scrotal revision. The operative report should describe the anatomy being corrected, the extent of the deformity, and the reconstruction performed. Medicare includes the day-before preoperative visit and 90 days of related postoperative care in the global surgical service. When multiple procedures occur 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 for this code. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 55180
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- 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 RVU11.49 · 62%
- Practice expense (office) RVU5.69 · 30%
- Malpractice RVU1.50 · 8%
364
Medicare services in 2024 · #3815 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.
55180 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
55150 is for excision of scrotal tissue. 55180 is for reconstructing scrotal anatomy rather than removing the scrotum as the operative objective.
No office rate
55120 targets removal of a scrotal lesion. 55180 targets correction of scrotal anatomy and contour.
Compare 55180 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
Vermont →
Office / nonfacility
Unavailable
Facility
$597.28
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 55180 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
6,345
- Code
- 55180
- Physician work
- 11.49
- Practice expense
- 5.69
- Malpractice
- 1.50
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.49 | × 1.000 | 11.4900 |
| Practice expense | 5.69 | × 0.990 | 5.6331 |
| Malpractice | 1.50 | × 0.506 | 0.7590 |
| Total RVUs | 17.8821 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$597.28
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.49 | 1 |
| Practice expense | 5.69 | 0.99 |
| Malpractice | 1.5 | 0.506 |
(11.49 × 1 + 5.69 × 0.99 + 1.5 × 0.506) × $33.4009 = $597.28
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.
55180 billing questions
How does this differ from 55175?
55180 is for a complicated reconstruction, such as scrotal reduction or correction of penoscrotal webbing. Use 55175 for a simple scrotal revision when the documented work does not support the more complex level.
Can modifier 50 be reported?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant surgeon be paid?
Assistant-at-surgery payment is allowed only when the record documents medical necessity. Co-surgeons and team surgery are not permitted.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
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.
6,34255120,,Removal of scrotum lesion,A,,5.58,3.63,NA,3.63,,0.71,9.92,9.92,0,090,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,34355150,,Removal of scrotum,A,,7.94,4.62,NA,4.62,,1.08,13.64,13.64,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,34455175,,Revision of scrotum,A,,5.72,3.70,NA,3.70,,0.75,10.17,10.17,0,090,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,34555180,,Revision of scrotum,A,,11.49,5.69,NA,5.69,,1.50,18.68,18.68,0,090,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,34655200,,Incision of sperm duct,A,,4.44,6.83,,2.73,,0.56,11.83,7.73,0,090,0.10,0.80,0.10,2,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,34755250,,Removal of sperm duct(s),A,,3.29,6.67,,2.82,,0.42,10.38,6.53,0,090,0.10,0.80,0.10,2,2,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,34855300,,Prepare sperm duct x-ray,A,,3.41,1.10,NA,1.10,,0.43,4.94,4.94,0,000,0.00,0.00,0.00,2,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817