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See a sample rate comparisonCPT 55540 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 RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 55540 |
| Medicaid Fee Schedule | View Medicaid rates for 55540 |
National average reimbursement for CPT 55540 by major payers:
$725.34
$713.65
$757.18
$882.12
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CPT 55540
5 of 25 sample ratesHigher to lower in this preview
Briarcliff Ambulatory Surgery Center Lp, Briarcliff Surgery Center
Briarcliff Ambulatory Surgery Center Lp
$3,570.00Published rateCenterview Surgery Center, LLC
Centerview Surgery Center LLC
$2,655.00Published rateOklahoma Spine Surgery Center
$1,673.00Published rateWaterside Ambulatory Surgical Center LLC
Waterside Ambulatory Surgical Ce
$1,211.00Published rateSan Francisco Surgery Center, Lp
$725.00Published rate
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See a sample payer proposalCPT 55540 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 55540 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 55540 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 55540. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 55540 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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