Summary & Overview
CPT 55440: Vasovasostomy, Surgical Reversal of Vasectomy
CPT code 55440 covers vasovasostomy, a surgical procedure to reverse a prior vasectomy by reconnecting the vas deferens. This code is nationally relevant as it addresses the growing demand for fertility restoration among men who have previously undergone sterilization. The procedure is performed by urology specialists, often in ambulatory surgical centers, and requires advanced microsurgical skills.
The publication provides a comprehensive overview of 55440, including clinical context, typical sites of service, and associated billing practices. Key payers such as Blue Cross Blue Shield are included in the analysis, offering insight into coverage and reimbursement trends. Readers will learn about relevant modifiers, associated taxonomies, and ICD-10 diagnoses commonly linked to vasovasostomy. Additionally, the article highlights related CPT codes to help clarify distinctions in surgical billing for male reproductive procedures.
This summary equips healthcare professionals, billing specialists, and policy analysts with essential information on coding, payer coverage, and clinical benchmarks for vasovasostomy, supporting accurate billing and informed decision-making in urology practice.
CPT Code Overview
CPT code 55440 represents vasovasostomy, vasovasorrhaphy, a surgical procedure performed to restore fertility by reconnecting the vas deferens after a prior vasectomy. This procedure is classified under urology and is typically performed in an ambulatory surgical center (Place of Service 24). Vasovasostomy is a complex microsurgical intervention that requires specialized expertise and is often sought by patients wishing to reverse sterilization. The procedure is significant in the context of reproductive health and surgical urology, offering an option for men seeking to regain fertility after vasectomy.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves a male patient who previously underwent a vasectomy and now desires to restore fertility. The patient presents to a urology clinic for evaluation. After counseling and assessment, the patient is scheduled for a vasovasostomy (CPT 55440) at an ambulatory surgical center (Place of Service 24). The procedure is performed by a urology physician, aiming to reconnect the vas deferens to allow sperm to pass through. Postoperative follow-up includes semen analysis and monitoring for complications.
Coding Specifications
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Modifier
51(Multiple Procedures):- Used when more than one procedure is performed during the same operative session. For example, if vasovasostomy is performed along with another urologic procedure.
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Modifier
59(Distinct Procedural Service):- Used to indicate that a procedure or service is distinct or independent from other services performed on the same day.
| Provider Taxonomy Code | Specialty Name |
|---|---|
208800000X | Urology Physician |
208C00000X | Colon & Rectal Surgery Physician |
2086S0120X | Surgery Physician |
Related Diagnoses
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N47.8- Other disorders of prepuce- May be relevant if prepuce abnormalities are identified during evaluation or surgery.
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N50.89- Other specified disorders of male genital organs- Used for male genital organ disorders not otherwise specified, which may be discovered during preoperative assessment.
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Z31.0- Encounter for reversal of previous sterilization- Directly relevant as the primary indication for vasovasostomy; patient is seeking reversal of vasectomy.
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Z98.52- Vasectomy status- Indicates the patient has a history of vasectomy, supporting medical necessity for reversal.
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N50.9- Disorder of male genital organs, unspecified- Used when a non-specific disorder is present, potentially related to the need for vasovasostomy.
Related CPT Codes
| CPT Code | Description | Clinical Relationship |
|---|---|---|
55250 | Vasectomy, unilateral or bilateral | Represents the original sterilization procedure; patients seeking vasovasostomy often have a history of vasectomy. |
55300 | Vasotomy, cannulization of vas deferens | Related as a diagnostic or preparatory procedure for vasovasostomy. |
55559 | Unlisted procedure, spermatic cord | Used when a unique or non-standard procedure involving the spermatic cord is performed. |
55650 | Vasovasostomy, with or without epididymovasostomy | Alternative or more complex procedure, may be used if epididymal involvement is required. |
55250and55440are commonly linked in patient history and workflow.55650may be used as an alternative or in conjunction with55440if additional repair is needed.
National Reimbursement Benchmarks
For CPT code 55440, the national mean rate for Blue Cross Blue Shield and BUCA (average commercial) is $80.02. Medicare rates are not available in the input for comparison. The mean rates for both commercial payers are identical, indicating no variation between these two payer categories at the national level.
Rate dispersion is minimal across both Blue Cross Blue Shield and BUCA, with the 25th, 50th, and 75th percentiles all at $80.00. This reflects a very tight distribution, meaning there is virtually no spread in rates among providers for these payers nationally.
The table and chart below present the full breakdown of national benchmarks for CPT code 55440 by payer.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.