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CPT 54650: Orchiopexy for Undescended Testicle

CPT code 54650 represents orchiopexy, a urologic surgical procedure to reposition an undescended testicle into the scrotum. The procedure is clinically important as it addresses cryptorchidism, reduces future infertility and malignancy risk, and is commonly performed in pediatric and some adult urology practices. Nationally, orchiopexy accounts for a measurable portion of pediatric urologic operative volume and influences surgical scheduling and facility resource use.

Key payers covered in this summary include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context and typical sites of service, common modifiers associated with surgical billing, and guidance on where to look for related billing and coding details. The publication also highlights benchmark considerations and policy-related updates that commonly affect authorization, bundling with hernia repair, and surgical facility claims processing.

This executive summary prepares clinicians, billing professionals, and policy analysts to understand the clinical purpose of CPT code 54650, typical care settings, and the payer mix relevant to national billing and coverage discussions. Data not available in the input is noted where applicable.

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Billing Code Overview

CPT code 54650 describes orchiopexy, a surgical procedure to move an undescended testicle into the scrotum. The procedure may be performed alone or in conjunction with a hernia repair when an associated inguinal hernia is present.

Service type: Surgical procedure (urologic)

Typical site of service: Hospital operating room or ambulatory surgery center, depending on patient factors and concurrent procedures.

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CPT 54650: Orchiopexy for Undescended Testicle

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Billing Code Overview

Service type: Surgical procedure (urologic)

Typical site of service: Hospital operating room or ambulatory surgery center, depending on patient factors and concurrent procedures.

Clinical & Coding Specifications

Clinical Context

A 6-year-old boy presents to pediatric urology with a nonpalpable right testicle noted since birth. Examination and ultrasound confirm an undescended testis in the inguinal canal. The surgical plan is an orchiopexy (CPT 54650) performed under general anesthesia in an ambulatory surgery center. Preoperative steps include informed consent, anesthesia evaluation, and prophylactic antibiotics per facility protocol. Intraoperative workflow: induction of general anesthesia, inguinal incision, mobilization of the spermatic cord, ligation of a patent processus vaginalis if present, creation of a subdartos pouch, and fixation of the testis within the scrotum. If a concurrent inguinal hernia is found, the surgeon repairs the hernia during the same session. Postoperative care includes analgesia, scrotal support, activity restrictions for several days, wound checks in clinic, and documentation of laterality and any complications. Billing captures laterality, any co-procedures (for example, hernia repair), and applicable modifiers for global period or unusual services. Typical site of service is an ambulatory surgery center or hospital outpatient department.

Coding Specifications

Modifier	Description	When to Use
`RT`	Right side	Use when the procedure is performed on the right testis
`LT`	Left side	Use when the procedure is performed on the left testis
`50`	Bilateral procedure	Use when bilateral orchiopexy is performed in the same session
`22`	Increased procedural services	Use when work required is substantially greater than typical (extensive dissection, dense adhesions)
`52`	Reduced services	Use when the service is partially reduced or not completed as described (aborted procedure)
`53`	Discontinued procedure	Use when the procedure is terminated due to extenuating circumstances after anesthesia has begun
`59`	Distinct procedural service	Use to indicate a separate, distinct procedure not normally billed together (when bundled rules permit)
`76`	Repeat procedure by same physician	Use if the same physician repeats the procedure within the global period (note: `76` is not in the provided list; see strict rules)
`78`	Unplanned return to the operating room for a related procedure during the global period	Use when patient returns to OR for a related complication during the global period
`24`	Unrelated E/M service during global period	Use for unrelated evaluation and management during postoperative global period

Taxonomy Code	Specialty	Notes
`2080P0207X`	Pediatric Urology	Pediatric urologists commonly perform `CPT 54650`
`2080P0201X`	Urology	General urologists perform orchiopexy in children and adolescents
`2080P0205X`	Pediatric Surgery	Pediatric surgeons with genitourinary experience may perform this procedure
`207P00000X`	General Surgery	General surgeons in some centers perform orchiopexy, particularly with associated hernia repair

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Q53.1`	Undescended testicle, right	Primary indication for right-sided orchiopexy
`Q53.2`	Undescended testicle, left	Primary indication for left-sided orchiopexy
`Q53.9`	Undescended testicle, unspecified	Used when laterality is not specified or documented
`K40.20`	Unilateral inguinal hernia, without obstruction or gangrene, without mention of reducibility	Commonly associated with undescended testis found during surgery
`K40.30`	Bilateral inguinal hernia, without obstruction or gangrene, without mention of reducibility	Billing when bilateral hernia repair is performed with orchiopexy
`N50.89`	Other specified disorders of male genital organs	Used for atypical scrotal/testicular conditions noted preoperatively
`Z48.02`	Encounter for removal of sutures	Postoperative code used in some settings for follow-up wound care

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`CPT 49505`	Repair of initial inguinal hernia, age 5 years or older; reducible	Performed when an inguinal hernia is identified and repaired concurrently with orchiopexy
`CPT 49500`	Repair of initial inguinal hernia, age 5 years or older; incarcerated or strangulated	Used if hernia is incarcerated/strangulated discovered during orchiopexy and requires emergent repair
`CPT 54140`	Circumcision, simple, using clamping device or other technique	May be billed in same patient encounter if concurrent circumcision is performed (rare)
`CPT 54240`	Orchiectomy, simple, for undescended testis (if nonviable)	Performed when testis is nonviable or atrophic and removal is indicated instead of orchiopexy
`CPT 99024`	Postoperative follow-up visit global period	Represents routine postoperative care during the global period (facility-specific reporting)

CPT 54600: Surgical Correction of Testicular Torsion

CPT-54620-CONTRALATERAL-ORCHIOPEXY-TESTICULAR-TORSION

CPT 54620: Contralateral Orchiopexy for Testicular Torsion

CPT-54640-ORCHIOPEXY-INGUINAL-SCROTAL-APPROACH

CPT 54640: Orchiopexy via Inguinal or Scrotal Approach

CPT-54660-TESTICULAR-PROSTHESIS-INSERTION-SEPARATE-PROCEDURE

CPT 54660: Testicular Prosthesis Insertion, Separate Procedure

CPT-54670-TESTICULAR-REPAIR-SUTURE-AFTER-INJURY

CPT 54670: Suture or Repair of Testis After Injury

CPT-54680-THIGH-TRANSPOSITION-OF-TESTIS-PRESERVATION

CPT 54680: Testis Transposition to Thigh for Preservation

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

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Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`RT`	Right side	Use when the procedure is performed on the right testis
`LT`	Left side	Use when the procedure is performed on the left testis
`50`	Bilateral procedure	Use when bilateral orchiopexy is performed in the same session
`22`	Increased procedural services	Use when work required is substantially greater than typical (extensive dissection, dense adhesions)
`52`	Reduced services	Use when the service is partially reduced or not completed as described (aborted procedure)
`53`	Discontinued procedure	Use when the procedure is terminated due to extenuating circumstances after anesthesia has begun
`59`	Distinct procedural service	Use to indicate a separate, distinct procedure not normally billed together (when bundled rules permit)
`76`	Repeat procedure by same physician	Use if the same physician repeats the procedure within the global period (note: `76` is not in the provided list; see strict rules)
`78`	Unplanned return to the operating room for a related procedure during the global period	Use when patient returns to OR for a related complication during the global period
`24`	Unrelated E/M service during global period	Use for unrelated evaluation and management during postoperative global period

Taxonomy Code	Specialty	Notes
`2080P0207X`	Pediatric Urology	Pediatric urologists commonly perform `CPT 54650`
`2080P0201X`	Urology	General urologists perform orchiopexy in children and adolescents
`2080P0205X`	Pediatric Surgery	Pediatric surgeons with genitourinary experience may perform this procedure
`207P00000X`	General Surgery	General surgeons in some centers perform orchiopexy, particularly with associated hernia repair

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Q53.1`	Undescended testicle, right	Primary indication for right-sided orchiopexy
`Q53.2`	Undescended testicle, left	Primary indication for left-sided orchiopexy
`Q53.9`	Undescended testicle, unspecified	Used when laterality is not specified or documented
`K40.20`	Unilateral inguinal hernia, without obstruction or gangrene, without mention of reducibility	Commonly associated with undescended testis found during surgery
`K40.30`	Bilateral inguinal hernia, without obstruction or gangrene, without mention of reducibility	Billing when bilateral hernia repair is performed with orchiopexy
`N50.89`	Other specified disorders of male genital organs	Used for atypical scrotal/testicular conditions noted preoperatively
`Z48.02`	Encounter for removal of sutures	Postoperative code used in some settings for follow-up wound care

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`CPT 49505`	Repair of initial inguinal hernia, age 5 years or older; reducible	Performed when an inguinal hernia is identified and repaired concurrently with orchiopexy
`CPT 49500`	Repair of initial inguinal hernia, age 5 years or older; incarcerated or strangulated	Used if hernia is incarcerated/strangulated discovered during orchiopexy and requires emergent repair
`CPT 54140`	Circumcision, simple, using clamping device or other technique	May be billed in same patient encounter if concurrent circumcision is performed (rare)
`CPT 54240`	Orchiectomy, simple, for undescended testis (if nonviable)	Performed when testis is nonviable or atrophic and removal is indicated instead of orchiopexy
`CPT 99024`	Postoperative follow-up visit global period	Represents routine postoperative care during the global period (facility-specific reporting)

CPT 54600: Surgical Correction of Testicular Torsion

CPT-54620-CONTRALATERAL-ORCHIOPEXY-TESTICULAR-TORSION

CPT 54620: Contralateral Orchiopexy for Testicular Torsion

CPT-54640-ORCHIOPEXY-INGUINAL-SCROTAL-APPROACH

CPT 54640: Orchiopexy via Inguinal or Scrotal Approach

CPT-54660-TESTICULAR-PROSTHESIS-INSERTION-SEPARATE-PROCEDURE

CPT 54660: Testicular Prosthesis Insertion, Separate Procedure

CPT-54670-TESTICULAR-REPAIR-SUTURE-AFTER-INJURY

CPT 54670: Suture or Repair of Testis After Injury

CPT-54680-THIGH-TRANSPOSITION-OF-TESTIS-PRESERVATION

CPT 54680: Testis Transposition to Thigh for Preservation

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 54650: Orchiopexy for Undescended Testicle

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Billing Code Overview

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CPT 54650: Orchiopexy for Undescended Testicle

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References