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See a sample rate comparisonCPT 89264 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.
Sperm Collection From Testicle, This Procedure Collects Fluid Or Tissue Directly From A Testicle To Find Out If Sperm Are Present. Fluid Is Taken To Help Diagnose A Blockage. Tissue Is Sampled When Other Methods Would Damage The Testicle.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Reproductive Medicine Procedures |
| Common Place of Service | 11 - Office 81 - Independent Laboratory |
| Common Modifiers | KX - Requirements specified in the medical policy have been met 59 - Distinct Procedural Service GY - Notice of Liability Not Issued, Not Required Under Payer Policy. |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 89264 |
National average reimbursement for CPT 89264 by major payers:
$117.02
$361.43
$318.26
$734.51
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CPT 89264
5 of 25 sample ratesHigher to lower in this preview
Canyon Atlantic
$111.44Published rateLubbock Heritage Hospital, LLC., Grace Surgical Hospital
Lubbock Heritage Hospital LLC
$52.47Published rateColumbia Plaza Medical Center Of Fort Worth Subsidiary Lp, Medical City Fort Worth
Columbia Plaza Medical Center Of Fort Worth Subsidiary Lp
$49.75Published rateColumbia Medical Center Of Plano Subsidiary Lp, Medical City Plano
$49.75Published rateTyler County Hospital District
$18.78Published rate
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See a sample payer proposalCPT 89264 vs. Other Reproductive Medicine Procedures Codes
The CPT 89264 code is part of the Pathology and Laboratory Procedures services used for Reproductive Medicine Procedures. 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 89264 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 |
|---|---|---|
| 89257-CPT | Low | Sperm Collection From Testicle, This Procedure Collects Fluid Or Tissue Directly From A Testicle To Find Out If Sperm Are Present. Fluid Is Taken To Help Diagnose A Blockage. Tissue Is Sampled When Other Methods Would Damage The Testicle. |
| 89264-CPT | Low | Sperm Collection From Testicle, This Procedure Collects Fluid Or Tissue Directly From A Testicle To Find Out If Sperm Are Present. Fluid Is Taken To Help Diagnose A Blockage. Tissue Is Sampled When Other Methods Would Damage The Testicle. |
| 89268-CPT | Moderate | Insemination Of Oocytes |
| 89272-CPT | Moderate | Fertility Procedure, Laboratory Procedure To Help Induce A Pregnancy Through In-Vitro Fertilization Or Another Infertility Treatment Technique. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 89264. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 89264 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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