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See a sample rate comparisonCPT 55559 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Unlisted Laparoscopy Procedure, Spermatic Cord
| 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 RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 55559 |
| Medicaid Fee Schedule | View Medicaid rates for 55559 |
National average reimbursement for CPT 55559 by major payers:
$1,186.42
$325.57
$1,876.57
$1,130.27
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CPT 55559
5 of 25 sample ratesHigher to lower in this preview
Arlington Surgery Center, LLC, Arlington Surgery Center Associates, Lp
Arlington Surgery Center LLC
$8,238.00Published rateAesthetic Associates Inc., P.S., Seattle Facial Plastic Surgery Center
Aesthetic Associates Inc Ps
$3,160.00Published rateSmart Pain Surgery Center At White Marsh, Clearway Surgery Center Of White Marsh
Smart Pain Surgery Center At White Marsh
$1,919.00Published rateBarnet Dulaney Perkins Eye Center, PC, Bdpec Showlow
Barnet Dulaney Perkins Eye Center PLLC
$1,550.00Published rateBirmingham Ambulatory Surgical Center, PLLC, Truvista Surgery Center
Birmingham Ambulatory Surgical
$898.00Published rate
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See a sample payer proposalCPT 55559 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 55559 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 55559 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 |
|---|---|---|
| 55520-CPT | Moderate | Remove Tissue From Testicle, Surgery To Remove Abnormal Or Injured Tissue From The Spermatic Cord A Part Of The Structure Of The Testicles. |
| 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. |
| 55559-CPT | High | Unlisted Laparoscopy Procedure, Spermatic Cord |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 55559. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 55559 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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