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See a sample rate comparisonCPT 55110 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.
Scrotal Exploration
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Male Genital System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 51 - Multiple procedures 78 - Return to OR - related procedure |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 55110 |
| Medicaid Fee Schedule | View Medicaid rates for 55110 |
National average reimbursement for CPT 55110 by major payers:
$500.92
$513.43
$542.63
$633.79
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CPT 55110
5 of 25 sample ratesHigher to lower in this preview
Lake George Surgery Center, LLC
$3,906.00Published rateHaymarket Surgery Center, LLC
Haymarket Surgery Center
$2,307.00Published rateCorona Surgical LLC, Corona Summit Surgical Center
Corona Surgical LLC
$1,658.00Published rateNorthern Ec LLC
$1,268.00Published rateLv Surgery Center LLC
$583.00Published rate
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See a sample payer proposalCPT 55110 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 55110 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 55110 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 |
|---|---|---|
| 55041-CPT | Moderate | Excision Hydrocele Bilateral |
| 55060-CPT | Moderate | Repair Of Tunica Hydrocele-Bottle |
| 55100-CPT | Moderate | Drainage Of Genital Injury, Procedure To Drain A Deep Abscess Or Hematoma (Pocket Of Infection Or Blood) From The Penis Scrotum Testicles Or Other Part Of The Genitals. |
| 55110-CPT | Moderate | Scrotal Exploration |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 55110. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 55110 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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