Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 55680 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.
Remove Genital Cyst, Surgery To Remove A Pocket Of Fluid (Cyst) From The Duct Located Near The Seminal Vesicles (Paired Glands That Produce Fluid For Semen).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Male Genital System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None LT - Left side of body 59 - Distinct Procedural Service 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 55680 |
| Medicaid Fee Schedule | View Medicaid rates for 55680 |
National average reimbursement for CPT 55680 by major payers:
$467.08
$462.89
$478.84
$574.57
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 55680.
CPT 55680
5 of 25 sample ratesHigher to lower in this preview
Greater Dayton Surgery Center LLC
Greater Dayton Surgery Center
$6,980.00Published ratePacific Endoscopy Center LLC
Pacific Endoscopy Center, LLC
$2,388.00Published rateLakeway Ambulatory Surgery Center, LLC, Lakeway Surgery Center
Lakeway Ambulatory Surgery Center LLC
$1,796.00Published rateOcean County Eye Associates LLC, Ocean County Eye Surgery Center
Ocean County Eye Associates, P.C.
$1,150.00Published rateGem State Endoscopy
$760.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 55680 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 55680 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 55680 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. |
| 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. |
| 55680-CPT | Moderate | Remove Genital Cyst, Surgery To Remove A Pocket Of Fluid (Cyst) From The Duct Located Near The Seminal Vesicles (Paired Glands That Produce Fluid For Semen). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 55680. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 55680 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 55680) and we'll show you how you compare in 15 minutes or less.