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CPT 55200: Vas Deferens Patency Assessment with Tubation
CPT code 55200 represents insertion of a tube into the vas deferens to assess and, if needed, relieve obstruction that may impair male fertility. This microsurgical diagnostic/operative procedure is an important part of urologic and reproductive care when evaluating obstructive azoospermia or other causes of impaired sperm transport. Nationally, it matters because it guides clinical decision-making around fertility preservation, downstream fertility interventions, and surgical management of obstructive causes.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical sites of service, along with the kinds of benchmarks and policy items commonly examined for this code—coverage patterns, payment considerations, and documentation elements that affect claim adjudication. The publication also outlines relevant clinical indications, expected service complexity, and where this procedure fits in care pathways for male fertility evaluation.
Data not available in the input for specific payer fee schedules, associated taxonomies, and ICD-10 diagnosis mappings. The content focuses on national-level clinical and billing context for CPT code 55200, helping payers, providers, and administrators understand what the code denotes and why it is used.
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Billing Code Overview
CPT code 55200 describes a surgical procedure in which a provider inserts a tube into the vas deferens to confirm patency and identify or relieve a blockage that could impair fertility. The procedure may include making an incision in the vas deferens when necessary and can be performed on one or both sides.
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Service type: Diagnostic/operative microsurgical procedure of the male reproductive tract to assess and address vas deferens patency
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Typical site of service: Ambulatory surgical center or hospital outpatient/inpatient operating room, depending on clinical complexity and anesthesia needs