55540
Active90-day globalRevise hernia & sperm veins
2026 Medicare payment
Estimated allowed amounts. Pick a locality or enter a ZIP; toggle modifiers to see how the payment rules change the number.
| Line | Qty | Non-facility (office) | Facility (hospital/ASC) |
|---|---|---|---|
| 55540 | 1 | $540.09 | $540.09 |
RVU breakdown (national)
Relative value units before geographic adjustment. Payment = (work×GPCIw + PE×GPCIpe + MP×GPCImp) × CF
| Row | Work RVU | PE RVU (office) | PE RVU (facility) | MP RVU | Total (office) |
|---|---|---|---|---|---|
| 55540 | 8.09 | 5.92 | 5.92 | 2.16 | 16.17 |
Payment policy for 55540
CMS's indicator fields, translated. These control which modifiers are payable and how.
Professional/technical (PC/TC)
pctc=0Physician service
Cannot be split into professional/technical components — modifiers 26 and TC don't apply.
Multiple procedures
mult_surg=2Standard MPPR
When billed with other procedures the same day: highest-valued paid 100%, the rest 50%.
Bilateral (modifier 50)
bilt_surg=1Bilateral 150%
With modifier 50 (both sides), payment is 150% of the single-side amount.
Assistant surgeon (80/81/82)
asst_surg=1Not payable
Assistant at surgery may not be paid for this procedure.
Co-surgeons (modifier 62)
co_surg=1Payable with documentation
Co-surgeons paid (62.5% each) if medical necessity is documented.
Team surgery (modifier 66)
team_surg=0Not permitted
Team surgery (mod 66) may not be paid for this procedure.
Global surgery package
Major surgery: payment covers the day before, the day of, and 90 days after. Of the total payment, 10% is attributed to pre-operative care, 80% to the procedure itself, and 10% to post-operative visits.
Source: pfs.data.cms.gov "Indicators for 2026", retrieved 2026-07-16; conversion factors $33.4009 / $33.5675 (QP) per CMS-1832-F. Estimated amounts — not billing or coding advice.