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CPT 55550: Laparoscopic Excision of Spermatic Cord Varices
CPT code 55550 denotes a laparoscopic varicelectomy of the spermatic cord — a minimally invasive surgical excision of enlarged veins in the scrotum performed to relieve pain or address fertility issues. This code matters nationally as an ambulatory or inpatient urologic procedure with implications for surgical scheduling, perioperative resource use, and payer coverage policies. The procedure is commonly provided by urologists or surgeons with laparoscopic expertise and is typically performed in hospital operating rooms or outpatient surgical centers.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical description, typical sites of service, payer coverage context, and connections to related coding. The publication summarizes relevant billing relationships and common coding alternatives for uncommon or unlisted laparoscopic spermatic cord procedures. It also highlights clinical scenarios that commonly lead to billing under this code, such as scrotal varices causing pain or infertility. The content is intended for billing personnel, practice managers, and clinical coders seeking a clear national-level reference for CPT code 55550 and its clinical application.
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Billing Code Overview
CPT code 55550 describes a laparoscopic procedure to excise abnormally enlarged veins of the spermatic cord within the scrotum. The procedure is performed using a laparoscope, a tubular instrument with a light source and camera, to access and remove dilated veins (varices) in the spermatic cord to relieve pain, discomfort, or to address infertility related to venous congestion.
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Service type: Minimally invasive laparoscopic surgical excision of spermatic cord varices
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Typical site of service: Hospital operating room or outpatient surgical center
National Reimbursement Benchmarks
Medicare’s mean allowed rate of $404.90 for CPT 55550 sits well below BUCA’s average commercial mean of $3,248.90, indicating a substantial gap between federal program reimbursement and this group’s commercial pricing. That spread highlights different contracting dynamics: Medicare clusters tightly around its localities with a reported interquartile band near $30 (P75 $418 minus P25 $388 = $30), while BUCA’s central tendency is much higher, reflecting broader commercial negotiations rather than fee‑schedule constraints.
Examining dispersion across payers, Blue Cross Blue Shield shows the widest IQR at $5,788.10 (P75 $7,404.50 minus P25 $1,616.40), followed by UnitedHealth Group at $499.40 and Cigna at $420.10. Aetna is comparatively tight with an IQR of $365.00. Medicare is the tightest by the IQR metric at $30.00, reflecting the smallest P75–P25 spread among the listed payers.