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CPT 55605 Fee Schedule

Last Verified: November 2025

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.

Vesiculotomy Complicated
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Male Genital System

Common Place of Service

11 - Office

24 - Ambulatory Surgical Center

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Common Modifiers

None

59 - Distinct Procedural Service

LT - Left side of body

51 - Multiple procedures

Complexity LevelModerate
CMS$512.37 Physician Fee Schedule

National average reimbursement for CPT 55605 by major payers:

bcbs

$739.91

uhc

$693.71

aetna

$720.59

cigna

$876.60

Preview provider-level rates for...
For billing codeCPT 55605
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 55605

United
55605$443.001326176215 - ENDOSCOPY CENTER OF ST THOMAS LLC, NGS ENDOSCOPY CENTER621512411 - (TN) ENDOSCOPY CENTER OF ST THOMAS LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
55605$640.001962007757 - SURGERY CENTER AT GROVE CREEK, LLC854085559 - (UT) SURGERY CENTER AT GROVE CREEK LLCUTAmbulatory Surgical Clinic/Center (261QA1903X)
United
55605$301.001740776517 - TAKLE EYE SURGERY CENTER LLC823838597 - (GA) TAKLE EYE SURGERY CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
55605$700.001467491407 - DEARBORN SURGERY CENTER, LLC, DEARBORN SURGERY CENTER383494075 - (MI) DEARBORN SURGERY CENTER, LLCMIAmbulatory Surgical Clinic/Center (261QA1903X)
United
55605$355.001831496231 - ANTELOPE VALLEY SURGERY CENTER, PC263584379 - (CA) ANTELOPE VALLEY SURGERY CENTER PCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
55605$658.001497090740 - OLOL PONTCHARTRAIN SURGERY CENTER, LLC, OUR LADY OF THE LAKE PONTCHARTRAIN SURGERY CENTER461379031 - (LA) OLOL PONTCHARTRAIN SURGERY CENTELAAmbulatory Surgical Clinic/Center (261QA1903X)
United
55605$440.001316341514 - MIAMI CHILDREN'S HOSPITAL AMBULATORY SURGERY CENTER, LLC463406805 - (FL) MIAMI CHILDRENS HOSPITAL AMBULAFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
55605$439.001255303517 - ST DOMINIC AMBULATORY SURGERY CENTER L L C640908713 - (MS) ST DOMINIC AMBULATORY SURGERY CENTER L L CMSAmbulatory Surgical Clinic/Center (261QA1903X)
United
55605$953.001871594275 - DESTIN SURGERY CENTER LLC593723179 - (FL) DESTIN SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
55605$455.001760445928 - ARIZONA ENDOSCOPY CENTER, LLC860908400 - (AZ) ARIZONA ENDOSCOPY CENTER LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
55605$591.001326549676 - CHATHAM ORTHOPAEDIC ASC, LLC, CHATHAM ORTHOPAEDIC SURGERY CENTER824075002GAAmbulatory Surgical Clinic/Center (261QA1903X)
United
55605$1352.001417919879 - HUNTERDON ENDOSURGERY CENTER223597546NJAmbulatory Surgical Clinic/Center (261QA1903X)
United
55605$445.001245288257 - SURGICAL CENTER OF GREENSBORO, LLC631251243 - (NC) SURGICAL CENTER OF GREENSBORO LLCNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
55605$376.001962148510 - PVSCG, LLC842112909 - (TX) PVSCG LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
55605$410.001740700111 - M. REZA MIZANI, M.D., P.A., TOTAL VASCULAR CARE200743330 - (TX) M. REZA MIZANI MD, PATXAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 55605 vs. Other Surgical Procedures on the Male Genital System Codes

The CPT 55605 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 55605 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.

CodeComplexityDescription
55520-CPTModerateExcision Lesion Spermatic Cord
55530-CPTModerateExcis.Varicocele/Liga-Spermatic Veins-Va
55540-CPTModerateExc.Varicocele/Lig-Sperm.Veins-Varico;He
55605-CPTModerateVesiculotomy Complicated

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 55605. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 55605 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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