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    OpenPayerBilling CodesRepair Procedures on the EpididymisCPT cpt-54901-epididymovasostomy-bilateral-epididymis-to-vas
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    CPT 54901: Bilateral Epididymovasostomy (Epididymis to Vas Anastomosis)

    Medicare pays $968 and commercial payers pay $2406 on average nationally for this procedure.

    CPT code 54901 describes a bilateral epididymovasostomy, the microsurgical anastomosis of the epididymis to the vas deferens performed to correct obstructive azoospermia from a blockage between the epididymis and vas; the service is a surgical reconstructive procedure typically performed in an operating room or ambulatory surgical center under microscopy and appropriate anesthesia for male infertility or obstructive sperm transport issues.

    For related coverage guidance, see recent payer policy updates: Removal of Implantable, Outpatient Surgical Procedures - Site of Service, Surgical Procedures.

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    National Reimbursement Benchmarks

    Medicare’s mean rate of $968.10 sits well below BUCA’s average commercial mean of $2,406.00, highlighting a substantial gap between federal reimbursement and this commercial benchmark. This gap of $1,437.90 underscores that commercial averages can be roughly 2.5x Medicare for CPT 54901, with individual commercial payers varying widely above and below BUCA’s mean.

    Dispersion measured by the interquartile range (P75 minus P25) is widest for Blue Cross Blue Shield at $3,267.10 and narrowest for Aetna at $918.00; UnitedHealth Group and Cigna show intermediate dispersion at $1,165.00 and $1,195.30 respectively, while BUCA’s IQR is $2,335.60 and Medicare’s is $57.00. These differences indicate that Blue Cross Blue Shield and BUCA exhibit the largest middle-50% spread, whereas Aetna and Medicare are comparatively tight.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Clinical & Coding Specifications

    Clinical Context

    A 34-year-old male with a 2-year history of primary infertility is evaluated after abnormal semen analyses showing low sperm counts and signs of obstructive azoospermia. Physical exam and scrotal ultrasound suggest epididymal obstruction bilateral. The urologist discusses surgical restoration of fertility and schedules a bilateral epididymovasostomy (54901) under general anesthesia. Preoperative workflow includes informed consent, baseline labs, urinalysis, sperm cryopreservation discussion, anesthesia assessment, and marking of laterality. Intraoperatively, the surgeon performs microsurgical anastomoses of the epididymal tubules to the vas deferens on both sides. Postoperative care includes short PACU recovery, analgesia, scrotal support, instructions to avoid heavy lifting and sexual activity for several weeks, and arranged follow-up with repeat semen analyses at 3 and 6 months to assess patency.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    54900Epididymovasostomy, anastomosis of epididymis to vas deferens; unilateral54900 represents the unilateral version; 54901 documents bilateral repair.

    Related Modifiers

    12 rows

    ModifierDescriptionWhen to Use
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    63Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…

    Showing 1–10 of 12

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208800000X
    208600000X
    208C00000X
    1744R1102X
    313M00000X
    207QB0002X
    213EP0504X
    332800000X

    Related ICD-10-CM Codes

    23 rows

    ICD-10-CM CodeDescription
    C62.10Malignant neoplasm of unspecified descended testis
    C62.90Malignant neoplasm of unspecified testis, unspecified whether descended or undescended
    E29.1Testicular hypofunction
    E29.8Other testicular dysfunction
    N44.00Torsion of testis, unspecified
    N45.1Epididymitis
    N45.2Orchitis
    N45.3Epididymo-orchitis
    N45.4Abscess of epididymis or testis
    N46.9Male infertility, unspecified

    Showing 1–10 of 23

    Related Payer Policy Updates

    Specialty: General Surgery1 / 2

    10 rows

    PolicyPayerEffective Date
    Removal of ImplantableBlue Cross Blue Shield - Rhode Island2026-10-01
    Outpatient Surgical Procedures - Site of ServiceUnitedHealthcare2026-09-01
    Surgical ProceduresUnitedHealthcare2026-09-01
    Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Site of Service for Ambulatory Surgical Procedures (ASC Select)Premera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Medical Necessity Guidelines Inpatient Surgical CareMass General Brigham Health Plan2026-08-01
    Outpatient Surgical Procedures - Site of Servicesierra health and life2026-08-01

    Related Codes

    CPT-54900-EPIDIDYMOVASOSTOMY-UNILATERAL-RECONSTRUCTIVE-SURGERY

    CPT 54900: Epididymovasostomy, Unilateral

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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