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CPT 55110 Fee Schedule

Last Verified: November 2025

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 FactDetail
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 LevelModerate
CMS$382.01 Physician Fee Schedule

National average reimbursement for CPT 55110 by major payers:

bcbs

$500.92

uhc

$513.43

aetna

$542.63

cigna

$649.20

Preview provider-level rates for...
For billing codeCPT 55110
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 55110

United
55110$1285.001528622321 - PREMIER-COVENANT ASTC LLC, PREMIER AMBULATORY SURGERY CENTER834550993 - (TN) PREMIERCOVENANT ASTC LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
55110$2135.001144380163 - THE CENTRE LLC352121237INAmbulatory Surgical Clinic/Center (261QA1903X)
United
55110$1401.001073556338 - VALDOSTA PODIATRY ASSOCIATES, PC, NORTH OAK AMBULATORY SURGERY CENTER261479859GAAmbulatory Surgical Clinic/Center (261QA1903X)
United
55110$4623.001063442077 - INOVA LOUDOUN AMBULATORY SURGERY203523190 - (VA) INOVA LOUDOUN AMBULATORY SURGERYVAAmbulatory Surgical Clinic/Center (261QA1903X)
United
55110$1800.001275510141 - NEOSPINE PUYALLUP SPINE CENTER, LLC, MICROSURGICAL SPINE CENTER203395071 - (WA) NEOSPINE PUYALLUP SPINE CENTER LLCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
55110$2839.001609920206 - UPMC JAMESON, UPMC JAMESON SHORT PROCEDURE UNIT250965406 - (PA) UPMCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
55110$562.001770599136 - RADIANCE-A PRIVATE OUTPATIENT SURGERY CENTER LLC, RADIANCE SURGERY CENTER510465402 - (PA) RADIANCE, LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
55110$1030.001386618783 - LEWES DE ENDOSCOPY ASC LLC, SEASIDE ENDOSCOPY PAVILION562299727 - (DE) LEWES DE ENDOSCOPY ASC LLCDEAmbulatory Surgical Clinic/Center (261QA1903X)
United
55110$1214.001386892230 - NORMAN ENDOSCOPY CENTER, LLC208716173 - (OK) NORMAN ENDOSCOPY CENTER LLCOKAmbulatory Surgical Clinic/Center (261QA1903X)
United
55110$1734.001881089076 - FREEMAN SURGICAL CENTER OF PITTSBURG, LLC473537670KSAmbulatory Surgical Clinic/Center (261QA1903X)
United
55110$2527.001730571118 - MEDSTAR MEDICAL GROUP462691028MDAmbulatory Surgical Clinic/Center (261QA1903X)
United
55110$1355.001295279586 - UNIVERSITY OF MIAMI, UMIAMI MEDICINE - OPHTHALMOLOGY (NAPLES BASCOM PALMER - ASC)592579938 - UNIVERSITY OF MIAMIFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
55110$1200.001457010209 - HNC, LLC, KAIZEN SURGERY CENTER364971722 - (CA) HNC LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
55110$638.001245399757 - KUMAR SURGICAL CENTER LLC383530839 - (MI) KUMAR SURGICAL CENTER LLCMIAmbulatory Surgical Clinic/Center (261QA1903X)
United
55110$3754.001295381572 - SOUTH SUBURBAN SURGICAL SUITES, LLC, SOUTH SUBURBAN SURGICAL SUITES842207819 - (IN) SOUTH SUBURBAN SURGICAL SUITES LLCINAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 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.

CodeComplexityDescription
55041-CPTModerateExcision Hydrocele Bilateral
55060-CPTModerateRepair Of Tunica Hydrocele-Bottle
55100-CPTModerateDrainage Scrotal Wall Abscess
55110-CPTModerateScrotal 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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