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    v1.0.30
    OpenPayerBilling CodesIntroduction Procedures on the Vas DeferensCPT cpt-55300-vas-deferens-incision-radiologic-examination
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    CPT 55300: Incision of Vas Deferens for Radiologic Evaluation

    Medicare pays $168 on average nationally for this procedure.

    CPT code 55300 describes a surgical procedure in which the provider makes an incision in the vas deferens to permit radiologic examination of the vas deferens and related structures to evaluate for obstructions affecting fertility; this is a diagnostic microsurgical/urologic procedure typically performed in an operating room or ambulatory surgical center and may be done unilaterally or bilaterally.

    For related coverage guidance, see recent payer policy updates: Infertility Treatment - Medical Policy, Cetrotide (cetrorelix acetate) Step Therapy, Infertility and Assisted Reproduction Services.

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    Clinical & Coding Specifications

    Clinical Context

    A 34-year-old male with a 12-month history of infertility is referred to a urologist for evaluation of possible obstructive azoospermia. Semen analyses show absent sperm with normal volume and normal serum testosterone; prior scrotal ultrasound is inconclusive for obstruction. The urologist schedules a diagnostic vasotomy with bilateral exploration and vasography under monitored anesthesia care or general anesthesia. In the operating room, after scrotal or inguinal exposure, the provider incises the vas deferens to introduce contrast and obtain fluoroscopic radiologic imaging of the vasal lumen and the epididymal and ejaculatory ductal anatomy to identify a site of obstruction or confirm patency. Intraoperative findings guide further management (repair, microsurgical reconstruction, or referral for assisted reproductive techniques). Typical site of service is an ambulatory surgery center or hospital outpatient operating room. Preoperative documentation includes infertility history, prior infections or surgery, informed consent describing risks of bleeding, infection, and potential impact on fertility, and radiologic consent. Postoperative documentation includes operative note describing unilateral or bilateral procedure, contrast findings, complications, and postoperative instructions.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    55400Vasectomy, bilateral (separate procedure)May be performed if sterilization is the goal or after diagnostic exploration if obstruction corrected and patient elects occlusion.
    54500Biopsy of the testis, simple; open, singlePerformed if concomitant testicular pathology is suspected during scrotal exploration.
    76930Ultrasound, scrotum and contentsPreoperative imaging commonly used to evaluate testicular and epididymal anatomy before operative exploration.
    55700Biopsy, prostate; needle or punch (separate procedure)Relevant when infertility evaluation includes ejaculatory duct or prostate pathology workup; may be staged or in separate settings.
    76942Ultrasonic guidance for needle placementMay be used if image-guided sampling or interventions are performed in conjunction with diagnostic evaluation.

    Related Modifiers

    10 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…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    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…
    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…
    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…
    73Modifier 73 indicates a facility-level outpatient hospital or ASC procedure that was discontinued after the patient was prepared and taken to the procedure/operating room but before any anesthesia…- When to use: Apply CPT modifier 73 on the FACILITY (outpatient hospital or ASC) claim when the patient has been fully prepared and physically taken into the procedure/operating room but the…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    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…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    246YC3301X
    246X00000X
    2080I0007X
    2083A0300X
    163WM0102X
    163WX0601X
    261QM0855X
    227900000X

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    N45.1Epididymitis
    N45.2Orchitis
    N45.3Epididymo-orchitis
    N46.9Male infertility, unspecified
    N47.1Phimosis
    N48.6Induration penis plastica
    N48.89Other specified disorders of penis
    N50.0Atrophy of testis
    N50.1Vascular disorders of male genital organs
    N50.89Other specified disorders of the male genital organs

    Showing 1–10 of 25

    Related Payer Policy Updates

    Specialty: Reproductive Health & Fertility1 / 2

    10 rows

    PolicyPayerEffective Date
    Infertility Treatment - Medical PolicyHealth-New-England2026-12-01
    Cetrotide (cetrorelix acetate) Step TherapyColorado Rocky Mountain Health Plans2026-11-01
    Infertility and Assisted Reproduction Servicespremerabluecrossofwashington2026-11-01
    Infertility and Assisted Reproduction Servicespremerabluecrossofwashington2026-11-01
    Infertility and Assisted Reproduction Servicespremerabluecrossofwashington2026-11-01
    Reproductive TechniquesBluecross Idaho2026-11-01
    Diagnostic Testing of Common Sexually Transmitted Infectionsblue cross blue shield - louisiana2026-09-15
    Menopur (menotropins) coverage for infertility treatment and fertility preservationUnitedHealthcare2026-09-01
    Cetrotide and ganirelix acetate prior authorizationColorado Rocky Mountain Health Plans2026-09-01
    Progesterone (Vaginal) for Individual and Family PlansCigna2026-08-01

    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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