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CPT 55400: Vasovasostomy (Vasectomy Reversal)

CPT code 55400 denotes vasovasostomy, a microsurgical technique to reverse vasectomy by reconnecting the vas deferens (or vas to epididymis) to restore fertility. The procedure is clinically significant because it offers men who previously underwent sterilization a surgical pathway to regain reproductive function; it also has implications for surgical scheduling, resource use in ambulatory surgery centers and hospitals, and payer coverage determinations.

Key payers in the national context include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise clinical and billing profile of CPT code 55400, including typical sites of service and how the code relates to adjacent procedures such as vasectomy and vasotomy. The publication reviews common clinical indications, associated diagnosis code concepts, related CPT procedures, and the service line context for urology and surgical specialties.

This summary provides a foundation for operational and policy discussions: how the procedure is coded, where it is typically performed, and what clinical scenarios prompt its use. The content is intended for coding professionals, surgical administrators, and payers seeking a clear reference on the clinical meaning and billing placement of CPT code 55400 at a national level.

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Billing Code Overview

CPT code 55400 describes vasovasostomy, a surgical procedure to reverse a prior vasectomy by reconnecting the vas deferens to restore passage of sperm. The service is a reconstructive reproductive surgery focused on re-establishing continuity between the vas deferens or between the vas and epididymis to enable fertility.

Service type: Surgical procedure — male reproductive tract reconstruction

Typical site of service: Hospital operating room or ambulatory surgery center

National Reimbursement Benchmarks

Medicare’s mean of $465.50 sits well below BUCA’s commercial average of $1,717.00, indicating that BUCA pays roughly $1,251.50 more on average than Medicare for CPT 55400. The gap highlights the persistent divergence between Medicare’s more compressed government schedule and a higher commercial benchmark represented by BUCA’s mean.

Dispersion (P75–P25) varies notably across payers: Blue Cross Blue Shield shows the widest spread at $3,384.20 (P75 $3,892.20 minus P25 $503.80), followed by UnitedHealth Group at $5,595.00 (P75 $1,107.30 minus P25 $547.80) — note UnitedHealth Group’s large upper-tail values relative to its P25. The tightest spreads are seen with Aetna at $255.00 (P75 $514.00 minus P25 $83.70) and Cigna at $567.50 (P75 $1,082.00 minus P25 $494.50), indicating more compressed commercial pricing around their midpoints.

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CPT 55400: Vasovasostomy (Vasectomy Reversal)

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Billing Code Overview

Service type: Surgical procedure — male reproductive tract reconstruction

Typical site of service: Hospital operating room or ambulatory surgery center

National Reimbursement Benchmarks

National Payer Mean Reimbursement Rates

Clinical & Coding Specifications

Clinical Context

A 38-year-old male who previously underwent a bilateral vasectomy presents to a urology clinic requesting reversal after deciding to attempt conception with his partner. Preoperative evaluation includes a focused history (time since vasectomy, prior scrotal surgeries, fertility history), scrotal exam, and semen analysis to establish baseline. Imaging is rarely required but scrotal ultrasound may be used if anatomic concerns exist. The patient is counseled about success rates, potential complications (infection, hematoma, chronic pain), and the intraoperative decision to perform either a vasovasostomy or a vasoepididymostomy based on intraluminal findings.

On the day of surgery, the procedure is typically performed in an ambulatory surgical center or hospital outpatient department under general or regional anesthesia with the patient in supine position. A scrotal incision is made to expose the vas deferens; the distal and proximal ends are inspected for patency and sperm presence. Microsurgical techniques are commonly used to create a watertight anastomosis (vas-to-vas or vas-to-epididymis). Intraoperative findings determine the complexity and operative time. Postoperative workflow includes short recovery, wound care instructions, activity restrictions, and scheduled semen analysis at approximately 6–12 weeks postoperatively to assess patency and sperm return.

Typical site of service: Ambulatory Surgical Center (ASC) or Hospital Outpatient Department (HOPD).

Service type: Microsurgical reconstructive urologic procedure to reverse prior sterilization (vasovasostomy or vasoepididymostomy).

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when only the physician professional component is billed separately (diagnostic interpretation or professional surgical service distinct from facility).
`50`	Bilateral procedure	Use when bilateral vasovasostomy is performed and payer requires explicit bilateral modifier reporting.
`51`	Multiple procedures	Use when additional unrelated surgical procedures are performed during the same operative session and payer requires a multiple procedure modifier.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as originally intended.
`53`	Discontinued procedure	Use when the procedure is started but discontinued for extenuating circumstances or patient safety.
`62`	Two surgeons	Use when two surgeons with different specialties perform distinct portions of the procedure concurrently.
`66`	Surgical team	Use when a surgical team approach is documented and payer recognizes team billing.
`73`	Discontinued outpatient procedure prior to anesthesia	Use when procedure is terminated after anesthesia administration but before start in the outpatient setting.
`78`	Unplanned return to OR following initial procedure	Use when a patient returns to the operating room for a related procedure during the postoperative global period.
`80`	Assistant surgeon	Use when an assistant surgeon provides intraoperative assistance and documentation supports separate assistant fee.
`62`	(duplicate entry avoided)	(see above)

Taxonomy Code	Specialty	Notes
`208800000X`	Urology Physician	Primary specialty performing vasovasostomy and vasoepididymostomy procedures.
`2086S0120X`	Surgery Physician	General or specialty surgeons who may perform reconstructive genital procedures in some settings.
`208C00000X`	Colon & Rectal Surgery Physician	Rarely involved; included in provided taxonomies but typically not the primary provider for this procedure.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N47.8`	Other disorders of the prepuce	May indicate concurrent foreskin pathology identified on exam; relevant when scrotal/genital exam reveals additional findings requiring attention.
`N50.89`	Other specified disorders of male genital organs	Captures non-specific male genital conditions that may be noted during preoperative assessment or that influence operative approach.
`Z31.0`	Encounter for reversal of previous sterilization	Directly describes the clinical reason for performing vasovasostomy to reverse prior sterilization.
`N50.9`	Disorder of male genital organs, unspecified	Used when a more specific diagnosis is not documented but a male genital procedure is performed.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`55250`	Vasectomy, unilateral or bilateral	Diagnostic or prior related procedure; documents original sterilization technique and may be referenced in surgical history.
`55300`	Vasotomy, cannulization of vas deferens	Related diagnostic or therapeutic procedure that may be used for evaluation or to restore patency in select cases.
`55500`	Excision of hydrocele; unilateral	Concurrent scrotal pathology that may be addressed during the same operative session if present.
`55600`	Vasectomy, with or without fascial interposition, unilateral or bilateral	Related sterilization procedure; relevant for historical coding and understanding prior operative anatomy.

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

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Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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.

Clinical & Coding Specifications

Clinical Context

Typical site of service: Ambulatory Surgical Center (ASC) or Hospital Outpatient Department (HOPD).

Service type: Microsurgical reconstructive urologic procedure to reverse prior sterilization (vasovasostomy or vasoepididymostomy).

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when only the physician professional component is billed separately (diagnostic interpretation or professional surgical service distinct from facility).
`50`	Bilateral procedure	Use when bilateral vasovasostomy is performed and payer requires explicit bilateral modifier reporting.
`51`	Multiple procedures	Use when additional unrelated surgical procedures are performed during the same operative session and payer requires a multiple procedure modifier.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as originally intended.
`53`	Discontinued procedure	Use when the procedure is started but discontinued for extenuating circumstances or patient safety.
`62`	Two surgeons	Use when two surgeons with different specialties perform distinct portions of the procedure concurrently.
`66`	Surgical team	Use when a surgical team approach is documented and payer recognizes team billing.
`73`	Discontinued outpatient procedure prior to anesthesia	Use when procedure is terminated after anesthesia administration but before start in the outpatient setting.
`78`	Unplanned return to OR following initial procedure	Use when a patient returns to the operating room for a related procedure during the postoperative global period.
`80`	Assistant surgeon	Use when an assistant surgeon provides intraoperative assistance and documentation supports separate assistant fee.
`62`	(duplicate entry avoided)	(see above)

Taxonomy Code	Specialty	Notes
`208800000X`	Urology Physician	Primary specialty performing vasovasostomy and vasoepididymostomy procedures.
`2086S0120X`	Surgery Physician	General or specialty surgeons who may perform reconstructive genital procedures in some settings.
`208C00000X`	Colon & Rectal Surgery Physician	Rarely involved; included in provided taxonomies but typically not the primary provider for this procedure.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N47.8`	Other disorders of the prepuce	May indicate concurrent foreskin pathology identified on exam; relevant when scrotal/genital exam reveals additional findings requiring attention.
`N50.89`	Other specified disorders of male genital organs	Captures non-specific male genital conditions that may be noted during preoperative assessment or that influence operative approach.
`Z31.0`	Encounter for reversal of previous sterilization	Directly describes the clinical reason for performing vasovasostomy to reverse prior sterilization.
`N50.9`	Disorder of male genital organs, unspecified	Used when a more specific diagnosis is not documented but a male genital procedure is performed.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`55250`	Vasectomy, unilateral or bilateral	Diagnostic or prior related procedure; documents original sterilization technique and may be referenced in surgical history.
`55300`	Vasotomy, cannulization of vas deferens	Related diagnostic or therapeutic procedure that may be used for evaluation or to restore patency in select cases.
`55500`	Excision of hydrocele; unilateral	Concurrent scrotal pathology that may be addressed during the same operative session if present.
`55600`	Vasectomy, with or without fascial interposition, unilateral or bilateral	Related sterilization procedure; relevant for historical coding and understanding prior operative anatomy.

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 55400: Vasovasostomy (Vasectomy Reversal)

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Billing Code Overview

National Reimbursement Benchmarks

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OpenPayer

CPT 55400: Vasovasostomy (Vasectomy Reversal)

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Billing Code Overview

National Reimbursement Benchmarks

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

References