No office rate
60540 covers open exploration or partial or complete adrenal removal; 60545 is for the more extensive operation that also excises adjacent tissue.
On this page
CMS RVU26D · Effective 2026-10-01
60540 Adrenal surgery Medicare reimbursement rates in Vermont
Reports open adrenal exploration, with or without biopsy, or partial or complete adrenal removal during operative treatment of an adrenal condition. Compare 60540 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 60540 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
$942.46
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.
Endocrine surgery
About 60540: Open adrenal exploration or removal
Reports open adrenal exploration, with or without biopsy, or partial or complete adrenal removal during operative treatment of an adrenal condition.
Code 60540 describes open operative exposure of an adrenal gland for assessment, with or without biopsy, or partial or complete removal. Surgeons may perform it for an adrenal mass or a hormonally active adrenal condition. It is typically performed in a hospital operating room by an endocrine or general surgeon, or another surgeon managing the adrenal disorder. The operative approach and extent of removal distinguish this service from laparoscopic adrenal surgery and more extensive adrenal resection.
Select the code from the operative report: document the side, open approach, whether the gland was explored or removed, and the extent of removal. If adjacent tissue is excised as part of a more extensive operation, compare the report with 60545. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 60540
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU17.57 · 58%
- Practice expense (office) RVU8.72 · 29%
- Malpractice RVU3.98 · 13%
321
Medicare services in 2024 · #3947 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.
60540 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
60650 describes laparoscopic adrenal exploration or removal. Use 60540 for the open approach.
No office rate
60500 concerns exploration of the parathyroid glands, not an adrenal operation. Select by the gland treated, not the similar exploration wording.
Compare 60540 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
$942.46
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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 60540 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
6,721
- Code
- 60540
- Physician work
- 17.57
- Practice expense
- 8.72
- Malpractice
- 3.98
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 17.57 | × 1.000 | 17.5700 |
| Practice expense | 8.72 | × 0.990 | 8.6328 |
| Malpractice | 3.98 | × 0.506 | 2.0139 |
| Total RVUs | 28.2167 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$942.46
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 17.57 | 1 |
| Practice expense | 8.72 | 0.99 |
| Malpractice | 3.98 | 0.506 |
(17.57 × 1 + 8.72 × 0.99 + 3.98 × 0.506) × $33.4009 = $942.46
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.
60540 billing questions
Does an adrenal biopsy change the code selection?
No. Exploration of the adrenal gland with or without biopsy is included in 60540; choose based on the operative approach and whether the gland was removed.
When should 60545 be considered instead?
Use 60545 when the adrenal operation includes excision of adjacent tissue as part of a more extensive resection. The operative report should establish that added extent.
How is a bilateral adrenal procedure reported?
CMS identifies 60540 as bilateral eligible: modifier 50 is paid at 150% when the procedure is performed bilaterally.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeons are paid only with supporting documentation; CMS does not permit team-surgery payment for this code.
Are related postoperative visits included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
6,71860520,,Removal of thymus gland,A,,16.73,8.63,NA,8.63,,4.07,29.43,29.43,0,090,0.09,0.82,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,71960521,,Removal of thymus gland,A,,18.70,8.99,NA,8.99,,4.68,32.37,32.37,0,090,0.09,0.82,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,72060522,,Removal of thymus gland,A,,22.89,10.38,NA,10.38,,5.66,38.93,38.93,0,090,0.09,0.82,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,72160540,,Explore adrenal gland,A,,17.57,8.72,NA,8.72,,3.98,30.27,30.27,0,090,0.09,0.82,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,72260545,,Explore adrenal gland,A,,20.41,9.87,NA,9.87,,4.88,35.16,35.16,0,090,0.09,0.82,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,72360600,,Remove carotid body lesion,A,,24.46,6.59,NA,6.59,,5.60,36.65,36.65,0,090,0.09,0.82,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,72460605,,Remove carotid body lesion,A,,31.16,5.78,NA,5.78,,7.97,44.91,44.91,0,090,0.09,0.82,0.09,2,0,2,1,0,9,,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