No office rate
Choose 55040 when the hydrocele involves the tunica vaginalis. Use 55500 when the hydrocele arises along the spermatic cord.
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CMS RVU26D · Effective 2026-10-01
55500 Hydrocele surgery Medicare reimbursement rates in Virginia
Reports surgical removal of a fluid-filled sac arising along the spermatic cord, rather than a hydrocele confined to the tunica vaginalis. Compare 55500 office and facility rates across CMS payment localities in Virginia.
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 55500 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$356.33–$406.08
2 of 2 localities have a 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.
Urologic surgery
About 55500: Spermatic cord hydrocele excision
Reports surgical removal of a fluid-filled sac arising along the spermatic cord, rather than a hydrocele confined to the tunica vaginalis.
This operation removes a hydrocele arising along the spermatic cord. The surgeon exposes the cord, separates the fluid-containing sac from nearby structures, and excises it. Urologists and other surgeons perform the procedure in an operating room, often for a symptomatic or persistent cord hydrocele. The key distinction is the sac’s location along the cord, not simply the presence of fluid in the scrotum.
Report one service for the treated side and document the cord location and operative removal. For bilateral procedures, modifier 50 is paid at 150%. When this procedure and other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. An assistant at surgery is paid only when medical necessity is documented; co-surgeons and team surgery are not permitted.
CMS billing rules for 55500
- 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 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 RVU6.06 · 55%
- Practice expense (office) RVU4.02 · 37%
- Malpractice RVU0.93 · 8%
130
Medicare services in 2024 · #4672 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.
55500 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
This code addresses excision of a spermatic cord hydrocele; 55060 is for repair of a hydrocele involving the tunica vaginalis.
$123.23–$142.58
55000 describes drainage of a tunica vaginalis hydrocele. It does not represent excision of a hydrocele sac along the spermatic cord.
No office rate
55520 is for removal of a spermatic cord lesion that is not a hydrocele; use 55500 when the excised lesion is a cord hydrocele.
Compare 55500 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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$406.08
Virginia →
Office / nonfacility
Unavailable
Facility
$356.33
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55500 billing questions
How is this different from surgery for a scrotal hydrocele?
This code is for a hydrocele arising along the spermatic cord. A hydrocele involving the tunica vaginalis is represented by a different code, such as 55040.
What documentation supports reporting this code?
The operative report should identify the hydrocele’s spermatic cord location and describe its surgical removal. A scrotal fluid collection alone does not establish that location.
Can modifier 50 be used for bilateral surgery?
Yes. CMS treats this as a bilateral procedure when reported with modifier 50 and pays it at 150%.
How does the multiple-procedure rule affect payment?
When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are paid at 50%.
What postoperative care is included?
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.
6,34755250,,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
6,34955400,,Repair of sperm duct,A,,8.39,4.20,NA,4.20,,1.08,13.67,13.67,0,090,0.10,0.80,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,35055500,,Removal of hydrocele,A,,6.06,4.02,NA,4.02,,0.93,11.01,11.01,0,090,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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