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See a sample rate comparisonCPT 54901 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 SG - Scene to Hospital ESRD facility 22 - Increased Procedural Services RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 54901 |
| Medicaid Fee Schedule | View Medicaid rates for 54901 |
National average reimbursement for CPT 54901 by major payers:
$1,366.14
$1,420.02
$1,473.86
$1,730.17
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CPT 54901
5 of 25 sample ratesHigher to lower in this preview
Peak One Surgery Center, LLC, Peak One Surgery Center
Peak One Surgery Center LLC
$9,210.00Published rateVictoria Ambulatory Surgery Center, Lp, The Surgery Center
Victoria Ambulatory Surgery Center Lp
$2,859.00Published rateCampbell Clinic Surgery Center, LLC
$1,698.00Published rateSarasota Endoscopy Asc LLC, Bayview Endoscopy Center
The Sarasota Endoscopy Asc, LLC
$1,200.00Published rateBean Center For Foot Surgery Inc, Sierra Center For Foot Surgery
Bean Center For Foot Surgery Inc
$830.00Published rate
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See a sample payer proposalCPT 54901 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 54901 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 54901 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 |
|---|---|---|
| 54840-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. |
| 54865-CPT | Moderate | Exploratory Genital Surgery, Exploratory Surgery Of The Epididymis At The Back Of The Testicle. The Procedure May Take A Sample Of Tissue For Testing (Biopsy). 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. |
| 54901-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 54901. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 54901 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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