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See a sample rate comparisonCPT 54550 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Explora For Undescended Testis (Inguinal Or Scrotal Area), Exploration For Undescended Testis (Inguinal Or Scrotal Area)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Male Genital System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 54550 |
| Medicaid Fee Schedule | View Medicaid rates for 54550 |
National average reimbursement for CPT 54550 by major payers:
$639.52
$654.85
$687.03
$805.40
Compare published rates across providers.
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CPT 54550
5 of 25 sample ratesHigher to lower in this preview
St. Joseph'S Surgery Center Lp
St Josephs Surgery Center Lp
$5,843.00Published rateLoyola Ambulatory Surgery Center At Oakbrook Lp
$3,350.00Published rateSurgcenter Of Bel Air
Surgcenter Of Bel Air, LLC
$2,117.00Published rateVision Care Center Of Idaho LLC
$1,602.00Published rateCataract & Laser Center, Inc.
The Cataract And Laser Center, I
$600.00Published rate
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See a sample payer proposalCPT 54550 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54550 code is part of the Surgery services used for Surgical Procedures on the Male Genital System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 54550 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 54500-CPT | Low | Biopsy Testis Needle |
| 54512-CPT | Moderate | Excision Of Extraparenchymal Lesion Of Testis |
| 54550-CPT | Moderate | Explora For Undescended Testis (Inguinal Or Scrotal Area), Exploration For Undescended Testis (Inguinal Or Scrotal Area) |
| 54600-CPT | Moderate | Surgery For Twisted Sperm Cord, Surgery To Untwist A Testicle That Has Wound Around Itself Cutting Off Blood Supply. The Testicle Is Anchored To The Wall Of The Scrotum To Prevent Another Occurrence. The Other Testicle May Be Anchored As Well. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54550. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54550 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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