2025 CPT code 54520
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Male Genital System Surgery Feed
Surgical removal of one or more testicles, with or without a testicular prosthesis, using a scrotal or inguinal approach.
Modifiers 50 (bilateral procedure), LT (left side), RT (right side), and others may be applicable depending on the circumstances of the procedure.
Medical necessity for orchiectomy is typically established based on the presence of testicular cancer, trauma, or other pathology requiring removal of the testicle. Documentation must clearly support the need for the procedure based on the clinical presentation and diagnosis.
The surgeon is responsible for performing the orchiectomy, including pre-operative planning, intraoperative technique, and postoperative care.
In simple words: The doctor removes one or both testicles through an incision in the scrotum or groin.An artificial testicle may be placed in its place.
Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach.The procedure involves the surgical removal of one or more testicles. This may be performed via a scrotal or inguinal approach.A testicular prosthesis may be inserted if clinically indicated. The procedure includes incision, identification and isolation of the spermatic cord, preservation of the ilioinguinal nerve, removal of the testicle(s), ligation of the spermatic cord, and closure of the incision. For bilateral procedures, report 54520 with modifier 50.
Example 1: A 70-year-old male presents with a large scrotal mass consistent with a testicular tumor.A simple orchiectomy is performed via a scrotal approach., A 45-year-old male with a history of testicular cancer undergoes a right inguinal orchiectomy as part of his cancer treatment. A testicular prosthesis is inserted., A 30-year-old male sustains traumatic injury to both testicles.A bilateral orchiectomy is performed.This would be coded with 54520 and modifier 50.
Preoperative diagnosis, operative report detailing the approach (scrotal or inguinal),description of the procedure, and any pathology results.For prosthesis placement, include information on the type of prosthesis used. If applicable,include pathology reports.
** This code encompasses both simple and subcapsular orchiectomies.Ensure accurate documentation to support the medical necessity and justify the chosen approach.
- Revenue Code: P5E (AMBULATORY PROCEDURES - OTHER)
- RVU: Information not available in provided text. Consult the AMA CPT codebook or CMS fee schedules for RVU data.
- Global Days: Information not provided.The global period for this procedure would need to be determined based on payer-specific guidelines and local practice.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is not applicable to this code as it represents the entire procedure.
- Fee Schedule: Information not available in provided text.Refer to historical CMS fee schedules for relevant data.
- Specialties:Urology
- Place of Service:Office, Ambulatory Surgical Center, Inpatient Hospital