Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.30
    OpenPayerBilling CodesOther Procedures on the ProstateCPT cpt-55870-ejaculatory-stimulation-and-semen-collection
    Ask Trek AI about this page

    CPT 55870: Electrical Ejaculation and Semen Collection

    Medicare pays $190 on average nationally for this procedure.

    CPT code 55870 describes electrical stimulation to induce ejaculation and collect a semen sample for laboratory analysis, a sperm retrieval and collection service typically performed in an outpatient clinic or urology/andrology procedural suite to obtain specimens for intrauterine insemination or artificial insemination in infertility care.

    For related coverage guidance, see recent payer policy updates: Dental Anesthesia Services, Anesthesia Services for Interventional Pain Management Procedures in an Adult, General Anesthesia and Conscious Sedation Services.

    Customize your policy alerts

    Sign up for cpt 55870 policy alerts

    Get alerted when payer policies referencing 55870 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Table of contents

    Progress1 / 6

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • Facility ComparisonBeds, revenue & payer mix
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical & Coding Specifications

    Clinical Context

    A 34-year-old man presents to a reproductive urology clinic with a history of infertility after 18 months of attempting conception with his partner. Semen analysis has been repeatedly unobtainable due to spinal cord injury with intact sacral reflexes. The provider schedules a posterior tibial or rectal electrical stimulation procedure to induce ejaculation and collect a semen sample for laboratory analysis and potential use for intrauterine insemination (IUI) or assisted reproductive technologies. The visit includes pre-procedure counseling, review of contraindications (cardiac pacemaker, active infection), obtaining informed consent, and sterile setup in an outpatient specialty clinic or ambulatory surgery center. During the procedure the provider applies controlled electrical current via a probe to stimulate ejaculation; the emitted specimen is collected, labeled, and sent to the andrology laboratory for semen analysis, processing, and cryopreservation or preparation for IUI if indicated. Billing uses 55870 for the ejaculation by electrical stimulation service; documentation includes indication, stimulation method, specimen collection, immediate specimen condition, and any complications or need for repeat attempts.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    89320Semen preparation for intrauterine insemination including incubation and washing when performedPerformed after 55870 when the collected specimen is processed for IUI.
    89321Sperm/oocyte preparation with cervical mucus testingMay be used in the laboratory workflow related to preparing semen for insemination or analysis.
    89300Sperm evaluation; presence and motility of sperm (eg, post-vasectomy)Baseline or confirmatory semen analysis often performed on the sample obtained via 55870.
    89250Semen analysis; postcoital test (Host test)Related laboratory assessments that may be part of the fertility workup alongside ejaculation induction.
    58570Hysteroscopy, diagnostic (separate reproductive procedure)Not directly part of 55870 but commonly performed in female fertility evaluation in the same treatment episode.
    99213Office or other outpatient visit, established patient, low to moderate complexityTypical evaluation and pre- or post-procedure visit associated with scheduling and follow-up for 55870.

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    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…
    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…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    2084P0800X
    174H00000X
    226000000X
    207QH0002X
    2471V0105X
    225B00000X
    207VH0002X
    246Y00000X

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Dental Anesthesia ServicesProvidence Health Plan2026-10-01
    Anesthesia Services for Interventional Pain Management Procedures in an AdultCigna2026-09-15
    General Anesthesia and Conscious Sedation ServicesUnitedHealthcare2026-09-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Elective Inpatient Services (for Idaho Only)UnitedHealthcare2026-06-01
    Sites of Servicepriority health2026-06-01
    Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Servicesuniverahealthcare2026-05-21

    Related Codes

    CPT-55873-PROSTATE-CRYOABLATION-ULTRASOUND-GUIDED

    CPT 55873: Prostate Cryoablation Under Ultrasound Guidance

    CPT-55874-PROSTATE-BIODEGRADABLE-SPACE-INJECTION-IMAGE-GUIDED

    CPT 55874: Perineal Image-Guided Biodegradable Prostate-Rectum Spacer Insertion

    CPT-55875-PROSTATE-SEED-IMPLANTATION-BRACHYTHERAPY-NEEDLE-PLACEMENT

    CPT 55875: Prostate Needle/Catheter Placement for Seed Implantation

    CPT-55876-PROSTATE-FIDUCIAL-MARKER-PLACEMENT-FOR-RADIOTHERAPY

    CPT 55876: Prostate Placement of Radiation Markers or Dosimeters

    CPT-55877-PROSTATE-IRE-ABLATION-PERCUTANEOUS

    CPT 55877: Prostate Irreversible Electroporation (Percutaneous Ablation)

    CPT-55880-TRANSRECTAL-HIFU-PROSTATE-ABLATION

    CPT 55880: Transrectal HIFU Ablation of Prostate Malignancy

    CPT-55881-TRANSURETHRAL-ULTRASOUND-ABLATION-PROSTATE-MRI-GUIDED

    CPT 55881: Transurethral Ultrasound Ablation of Prostate Tissue, MRI-Guided

    CPT-55882-TRANSURETHRAL-ULTRASOUND-ABLATION-PROSTATE-MRI-GUIDED

    CPT 55882: Transurethral Ultrasound Ablation of Prostate Tissue

    CPT-55899-MALE-GENITAL-SYSTEM-UNLISTED-PROCEDURE

    CPT 55899: Unlisted Procedure, Male Genital System

    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.
    Published by

    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.