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See a sample rate comparisonCPT 54900 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.
Surgery To Reverse Vasectomy, Surgery To Remove Or Bypass A Blockage In The Flow Of Sperm And Semen Through The Genital Structure. The Procedure Involves The Epididymis And Vas Deferens On One Or Both Sides.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Male Genital System |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 54900 |
| Medicaid Fee Schedule | View Medicaid rates for 54900 |
National average reimbursement for CPT 54900 by major payers:
$1,025.36
$1,057.86
$1,094.14
$1,300.83
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CPT 54900
5 of 25 sample ratesHigher to lower in this preview
Saint Luke'S North Surgery Center, LLC
Saint Lukes North Surgery Center LLC
$5,177.00Published rateAdvanced Endoscopy & Surgical Center LLC, Advanced Endoscopy & Surgical Center
Advanced Endoscopy Surgical Center LLC
$2,795.00Published rateBakersfield Specialists Surgical Center, LLC
Bakersfield Specialists Surgical Center
$1,650.00Published rateEndotech, LLC
Endotech LLC
$1,150.00Published rateEye Physicians Of Sussex County, Eye Physicians Of Sussex County Surgical Suite
Eye Physicians Of Sussex County
$549.00Published rate
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See a sample payer proposalCPT 54900 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54900 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 54900 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 |
|---|---|---|
| 54700-CPT | Moderate | Drainage Of Genital Injury, Procedure To Drain A Deep Abscess Or Hematoma (Pocket Of Infection Or Blood) From The Penis Scrotum Testicles Or Other Part Of The Genitals. |
| 54800-CPT | Low | Sperm Storage Tube Biopsy, A Procedure To Remove A Sample Of Tissue For Testing (Biopsy) From The Epididymis (At The Back Of The Testicles). The Epididymis Stores And Transports Sperm. |
| 54830-CPT | Moderate | Surgery On Testicle, Surgery To Remove Abnormal Tissue Or A Fluid Sac (Spermatocele) From Around The Epididymis In The Testicle. The Epididymis Stores And Transports Sperm. |
| 54900-CPT | High | Surgery To Reverse Vasectomy, Surgery To Remove Or Bypass A Blockage In The Flow Of Sperm And Semen Through The Genital Structure. The Procedure Involves The Epididymis And Vas Deferens On One Or Both Sides. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 54900. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54900 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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