No office rate
55110 describes operative inspection. Use 54600 when the surgeon treats testicular torsion; do not separately report exploration when it is integral to that treatment.
On this page
CMS RVU26D · Effective 2026-10-01
55110 Scrotal exploration Medicare reimbursement rates in Wisconsin
Reports operative inspection of the scrotal contents when examination is needed to investigate findings such as acute scrotal pain or traumatic injury. Compare 55110 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 55110 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
$337.80
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 55110: Scrotal surgical exploration
Reports operative inspection of the scrotal contents when examination is needed to investigate findings such as acute scrotal pain or traumatic injury.
A urologist performs an operative inspection of the scrotal contents, typically in an operating room when examination or other evaluation has not resolved a significant concern. Examples include acute scrotal findings requiring direct assessment or blunt scrotal trauma with concern for injury to the testis or surrounding structures. The operative report should identify the indication, the structures inspected, the findings, and any treatment performed.
Report 55110 for the exploration itself; when a specific condition is treated, select the code for that definitive procedure rather than treating exploration as a separate service. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to standard multiple procedure reduction. Do not append modifier 50. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 55110
- 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
- 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 RVU6.17 · 57%
- Practice expense (office) RVU3.84 · 35%
- Malpractice RVU0.86 · 8%
415
Medicare services in 2024 · #3708 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.
55110 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
$232.85
55100 describes drainage of a scrotal abscess. Choose it when abscess drainage is performed rather than reporting exploration alone.
No office rate
55120 describes removal of a scrotal lesion. Use it when lesion removal is the operative service, not exploration alone.
No office rate
54520 describes simple removal of a testis. Use it when the testis is removed, rather than when the service is limited to scrotal exploration.
Compare 55110 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
$337.80
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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 55110 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
6,341
- Code
- 55110
- Physician work
- 6.17
- Practice expense
- 3.84
- Malpractice
- 0.86
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.17 | × 1.000 | 6.1700 |
| Practice expense | 3.84 | × 0.958 | 3.6787 |
| Malpractice | 0.86 | × 0.308 | 0.2649 |
| Total RVUs | 10.1136 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$337.80
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.17 | 1 |
| Practice expense | 3.84 | 0.958 |
| Malpractice | 0.86 | 0.308 |
(6.17 × 1 + 3.84 × 0.958 + 0.86 × 0.308) × $33.4009 = $337.80
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.
55110 billing questions
When should 55110 be chosen instead of a procedure code for a specific condition?
Use 55110 when operative inspection is the service performed. If the surgeon treats a diagnosed condition, such as torsion, abscess, or a scrotal lesion, report the code describing that treatment.
Can exploration be reported separately with treatment performed during the same operation?
Do not separately report exploration when it is part of the operative work for a definitive procedure. The operative report should support any separately reported service.
Does 55110 take modifier 50?
No. CMS identifies bilateral adjustment as inappropriate for this code; do not append modifier 50.
What global care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 55110. 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.
6,33855041,,Removal of hydroceles,A,,8.33,4.67,NA,4.67,,1.10,14.10,14.10,0,090,0.10,0.80,0.10,2,2,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,33955060,,Repair of hydrocele,A,,6.00,3.81,NA,3.81,,0.79,10.60,10.60,0,090,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,34055100,,Drainage of scrotum abscess,A,,2.39,4.66,,2.14,,0.38,7.43,4.91,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,34155110,,Explore scrotum,A,,6.17,3.84,NA,3.84,,0.86,10.87,10.87,0,090,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,34255120,,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
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,,,,,,