No office rate
54840 is for spermatocele excision. Use 54830 for excision of a different epididymal lesion.
On this page
CMS RVU26D · Effective 2026-10-01
54840 Spermatocele removal Medicare reimbursement rates in Wisconsin
Reports surgical removal of a spermatocele arising from the epididymis, including cases where the surgeon also removes epididymal tissue. Compare 54840 office and facility rates across CMS payment localities in Wisconsin.
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 54840 in Wisconsin?
Wisconsin 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
$278.94
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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.
Urology surgery
About 54840: Spermatocele excision
Reports surgical removal of a spermatocele arising from the epididymis, including cases where the surgeon also removes epididymal tissue.
A urologist typically performs this scrotal operation to remove a spermatocele, a fluid-filled cyst arising from the epididymis. The procedure may include removal of epididymal tissue when needed to excise the cyst. It is commonly performed in an operating room or ambulatory surgery setting for a symptomatic or enlarging spermatocele.
Choose this code when the operative report documents excision of a spermatocele; removal of epididymal tissue as part of that excision is included. Document the cyst’s location and the work performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When other procedures occur in the same session, the highest-valued procedure is paid in full and additional procedures are subject to the standard multiple-procedure reduction. For bilateral reporting with modifier 50, Medicare pays at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 54840
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.14 · 57%
- Practice expense (office) RVU3.14 · 35%
- Malpractice RVU0.66 · 7%
2.4K
Medicare services in 2024 · #2319 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.
54840 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
No office rate
54800 represents epididymal biopsy for sampling; 54840 represents surgical removal of a spermatocele.
No office rate
54860 is for unilateral removal of the epididymis, rather than excision of a spermatocele with or without removal of epididymal tissue.
Compare 54840 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
Wisconsin →
Office / nonfacility
Unavailable
Facility
$278.94
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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 54840 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
6,330
- Code
- 54840
- Physician work
- 5.14
- Practice expense
- 3.14
- Malpractice
- 0.66
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.14 | × 1.000 | 5.1400 |
| Practice expense | 3.14 | × 0.958 | 3.0081 |
| Malpractice | 0.66 | × 0.308 | 0.2033 |
| Total RVUs | 8.3514 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$278.94
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.14 | 1 |
| Practice expense | 3.14 | 0.958 |
| Malpractice | 0.66 | 0.308 |
(5.14 × 1 + 3.14 × 0.958 + 0.66 × 0.308) × $33.4009 = $278.94
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.
54840 billing questions
How is 54840 different from 54830?
Use 54840 for excision of a spermatocele. Code 54830 describes excision of another epididymal lesion, rather than a spermatocele.
Can epididymectomy be reported separately with 54840?
The spermatocele excision may include removal of epididymal tissue. Do not separately report an epididymectomy for tissue removal that is part of excising the spermatocele.
When is 54800 more appropriate?
Use 54800 when the service is an epididymal biopsy for tissue sampling, rather than surgical excision of a spermatocele.
What supports reporting 54840?
The operative note should identify a spermatocele and document its excision, including the relevant epididymal site and work performed.
How does Medicare handle bilateral reporting?
When the procedure is performed bilaterally, Medicare pays 150% with modifier 50. Other procedures in the same session are subject to the multiple-procedure reduction.
Can an assistant or co-surgeon be billed?
Medicare payment for an assistant at surgery is restricted for this code. Co-surgeons and team surgery are not permitted.
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.
6,32754700,,I&d epdidyms tstis&/scrot sp,A,,3.38,2.13,NA,2.13,,0.48,5.99,5.99,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,32854800,,Biopsy of epididymis,A,,2.27,0.78,NA,0.78,,0.28,3.33,3.33,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,32954830,,Remove epididymis lesion,A,,5.86,3.77,NA,3.77,,0.78,10.41,10.41,0,090,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,33054840,,Remove epididymis lesion,A,,5.14,3.14,NA,3.14,,0.66,8.94,8.94,0,090,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,33154860,,Removal of epididymis,A,,6.78,3.95,NA,3.95,,0.88,11.61,11.61,0,090,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,33254861,,Removal of epididymis,A,,9.46,4.89,NA,4.89,,1.22,15.57,15.57,0,090,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,33354865,,Explore epididymis,A,,5.63,3.71,NA,3.71,,0.72,10.06,10.06,0,090,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,