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See a sample rate comparisonCPT 55535 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.
Surgery On Testicle Veins, Surgery To Remove An Abnormally Enlarged Portion Of One Or More Veins Inside A Testicle. The Procedure May Be Done At The Same Time As A Hernia Repair.
| 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 50 - Bilateral Procedure |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 55535 |
| Medicaid Fee Schedule | View Medicaid rates for 55535 |
National average reimbursement for CPT 55535 by major payers:
$569.67
$571.10
$606.77
$705.87
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CPT 55535
5 of 25 sample ratesHigher to lower in this preview
Christus Santa Rosa Outpatient Surgery, Christus Physicians Surgery Center - New Braunfels
$6,316.00Published rateClinic Surgery Center, LLC, New Tampa Surgery Center
Clinic Surgery Center LLC
$2,700.00Published rateTexoma Outpatient Surgery Center, Inc.
Texoma Outpatient Surgery Center Inc
$1,900.00Published rateThe Scranton PA Endoscopy Asc Lp, The Scranton Endoscopy Center
The Scranton PA Endoscopy Asc Lp
$1,273.00Published rateMarion Eye Surgery Center LLC
$655.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 55535 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 55535 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 55535 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 |
|---|---|---|
| 55530-CPT | Moderate | Surgery On Testicle Veins, Surgery To Remove An Abnormally Enlarged Portion Of One Or More Veins Inside A Testicle. The Procedure May Be Done At The Same Time As A Hernia Repair. |
| 55535-CPT | Moderate | Surgery On Testicle Veins, Surgery To Remove An Abnormally Enlarged Portion Of One Or More Veins Inside A Testicle. The Procedure May Be Done At The Same Time As A Hernia Repair. |
| 55540-CPT | Moderate | Surgery On Testicle Veins, Surgery To Remove An Abnormally Enlarged Portion Of One Or More Veins Inside A Testicle. The Procedure May Be Done At The Same Time As A Hernia Repair. |
| 55550-CPT | Moderate | Surgery On Testicle Veins, Surgery To Remove An Abnormally Enlarged Portion Of One Or More Veins Inside A Testicle. The Procedure May Be Done At The Same Time As A Hernia Repair. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 55535. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 55535 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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