Summary & Overview
CPT 54900: Unilateral Epididymovasostomy, Surgical Repair
CPT 54900 denotes a unilateral epididymovasostomy, a microsurgical repair connecting the epididymis to the vas deferens to address obstructive causes of male infertility. As a specialized surgical code, it is relevant to urology and surgical practices that perform fertility-restorative procedures in outpatient hospital settings. Nationally, the code is important for procedural classification, billing consistency, and aligning clinical documentation with surgical service lines.
Key payers included in this overview are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the procedure and its clinical context, typical site-of-service expectations, common billing modifiers used with intricate surgical work, associated provider taxonomies, and typical ICD-10 indications that justify medical necessity. The publication also highlights the closely related bilateral code CPT 54901 for comparative coding reference.
This summary prepares clinical administrators, coding professionals, and policy analysts to understand coding application for epididymovasostomy, where to expect services to be performed, and which payers commonly cover or process claims for this surgical intervention. Data not available in the input is noted where applicable in detailed sections.
CPT Code Overview
CPT 54900 describes a repair procedure on the epididymis specifically an epididymovasostomy, unilateral. This is a surgical procedure that restores continuity between the epididymis and the vas deferens to address obstructive azoospermia or other causes of post-vasectomy infertility. The typical site of service is Outpatient Hospital (POS 22).
Clinical & Coding Specifications
Clinical Context
A male patient with obstructive azoospermia secondary to epididymal obstruction presents for surgical reversal via epididymovasostomy. The patient typically undergoes preoperative evaluation by a urologist, including semen analysis and scrotal ultrasound, and is scheduled to receive the unilateral microsurgical anastomosis of the vas deferens to the epididymal tubules under general or regional anesthesia in an outpatient hospital setting (POS 22). Intraoperative findings guide repair; if unilateral disease is identified, the procedure corresponds to the unilateral code 54900. Postoperative workflow includes recovery in PACU, short-term pain control, wound care instructions, and follow-up semen analyses to assess patency.
Coding Specifications
-
Modifiers
-
51- Multiple Procedures: Used when54900is performed in the same operative session with additional distinct surgical procedures; typically reported in conjunction with a primary procedure code according to payer rules. -
59- Distinct Procedural Service: Used when54900represents a distinct procedural service separate from other services performed on the same day, when documentation supports distinct procedural circumstances. -
Provider Taxonomies