Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 55000 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.
Punctur Aspirat Of Hydrocele Tunica Vaginalis W//W/O In, Puncture Aspiration Of Hydrocele Tunica Vaginalis With Or Without In
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Male Genital System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 55000 |
| Medicaid Fee Schedule | View Medicaid rates for 55000 |
National average reimbursement for CPT 55000 by major payers:
$166.62
$159.36
$173.46
$146.30
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 55000.
CPT 55000
5 of 25 sample ratesHigher to lower in this preview
Alaska Surgery Center, Limited Partnership
Alaska Surgery Center Limited Partnership
$2,804.00Published rateSurgery Center Of Fort Wayne
Surgery Center Of Fort Wayne LLC
$944.00Published rateThe Endoscopy Center At Bainbridge LLC
$627.00Published rateSouthwestern Eye Center Ltd, Southwestern Eye Center
Southwestern Eye Center, Ltd.
$367.00Published rateDeaconess Hospital, Inc, <Unavail>
Deaconess Hospital Inc
$206.25Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 55000 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 55000 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 55000 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 |
|---|---|---|
| 54901-CPT | High | Surgery To Reverse Vasectomy, Surgery To Remove Or Bypass A Blockage In The Flow Of Sperm And Semen Through The Genital Structure. The Procedure Involves The Epididymis And Vas Deferens On One Or Both Sides. |
| 55000-CPT | Low | Punctur Aspirat Of Hydrocele Tunica Vaginalis W//W/O In, Puncture Aspiration Of Hydrocele Tunica Vaginalis With Or Without In |
| 55040-CPT | Moderate | Excision Of Hydrocele; Unilateral |
| 55041-CPT | Moderate | Excision Hydrocele Bilateral |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 55000. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 55000 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 55000) and we'll show you how you compare in 15 minutes or less.