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See a sample rate comparisonCPT 55200 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Test Of Sperm Passage, Testing Performed On One Or Both Vas Deferens The Tubes That Carry Sperm. The Test Verifies Passage Of Sperm Through The Vas. A Sample Of Sperm May Be Collected.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Male Genital System |
| Common Place of Service | 11 - Office 21 - Inpatient Hospital |
| Common Modifiers | None AG - Primary physician 51 - Multiple procedures 50 - Bilateral Procedure 78 - Return to OR - related procedure 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 55200 |
| Medicaid Fee Schedule | View Medicaid rates for 55200 |
National average reimbursement for CPT 55200 by major payers:
$513.79
$585.29
$563.23
$668.49
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CPT 55200
5 of 25 sample ratesHigher to lower in this preview
Sherman Endoscopy Center, LLC
Sherman Endoscopy Center LLC
$3,150.00Published rateSurgcenter Of Silver Spring, LLC
Surgcenter Of Silver Spring LLC
$2,353.00Published rateAthens Orthopedic Clinic Ambulatory Surgery Center-Loganville, LLC
$1,597.00Published rateBaptist Surgery And Endoscopy Centers LLC, Baptist Health Surgery Center At Northpoint
$1,062.00Published rateAsc Development Company, LLC
Asc Development Company LLC
$691.00Published rate
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See a sample payer proposalCPT 55200 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 55200 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 55200 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 |
|---|---|---|
| 55120-CPT | Moderate | Removal Fb Scrotum |
| 55150-CPT | Moderate | Surgery On The Scrotum, Surgical Removal Of Excess Or Diseased Skin From The Scrotum. The Procedure May Involve Skin Grafts For Reconstruction. |
| 55175-CPT | Moderate | Surgery On The Scrotum, Surgery To Repair Or Reconstruct The Scrotum. The Procedure May Include Use Of Skin Grafts Flaps Or Patches. |
| 55200-CPT | Moderate | Test Of Sperm Passage, Testing Performed On One Or Both Vas Deferens The Tubes That Carry Sperm. The Test Verifies Passage Of Sperm Through The Vas. A Sample Of Sperm May Be Collected. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 55200. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 55200 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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