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See a sample rate comparisonCPT 55400 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.
Vasovasostomy Unilateral
| 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 50 - Bilateral Procedure RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 55400 |
| Medicaid Fee Schedule | View Medicaid rates for 55400 |
National average reimbursement for CPT 55400 by major payers:
$702.15
$673.30
$724.01
$824.75
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CPT 55400
5 of 25 sample ratesHigher to lower in this preview
Medical City Surgery Center Of Frisco, LLC
Medical City Surgery Center Of Frisco LLC
$3,681.00Published ratePhysicians Surgery Center At Good Samaritan, LLC, Good Samaritan Surgery Center
Physicians Surgery Center At Good Samaritan LLC
$2,040.00Published rateRsc Surgery Center, LLC
$1,526.00Published rateOrtho Central
$1,011.00Published rateAmbulatory Surgical Care, LLC
Ambulatory Surgical Care LLC
$450.00Published rate
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See a sample payer proposalCPT 55400 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 55400 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 55400 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 |
|---|---|---|
| 55250-CPT | Moderate | Male Sterilization, Surgery To Prevent A Man Being Able To Get A Woman Pregnant By Removing Or Cutting The Vas Deferens (Vasectomy). |
| 55300-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. |
| 55400-CPT | Moderate | Vasovasostomy Unilateral |
| 55500-CPT | Moderate | Remove Fluid From Testicle, Surgery To Remove A Sac Of Fluid (Hydrocele) That Has Formed Around The Spermatic Cord A Part Of The Structure Of The Testicles. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 55400. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 55400 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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