Billing code 55200: VasotomyMedicare rate & RVUs
Reports a surgeon’s incision into the vas deferens, including access for vasography or another procedure requiring entry into the duct.
Medicare pays $395.13 for 55200 nationally in the office and $258.19 in a hospital or facility. Local office rates run $353.89–$503.60.
Medicare rate · 55200
Vasotomy
Swap in your local Medicare rate.
- Work RVUs
- 4.44
- Total RVUs
- 11.83
- Global days
- 090
National rate · 2026
$395.13
Office setting, before claim adjustments.
See every locality for 55200 → · Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 10 sections
What 55200 covers
A vasotomy is a surgical opening of the vas deferens. A urologist typically performs it in an operating room or procedure setting when access to the duct is needed, including for vasography. The code covers the incision itself; it is distinct from removing or interrupting the vas deferens for sterilization and from reconstructing a divided duct.
Report 55200 when the operative note documents the vas deferens incision and the procedure performed. The code is priced as bilateral, so modifier 50 does not increase payment. It has a 90-day global period, which includes the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 55200 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$353.89 to $503.60
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $358.50 | $238.67 |
| Alaska* | $475.71 | $329.87 |
| Arizona | $385.37 | $252.67 |
| Arkansas | $353.89 | $236.26 |
| Atlanta | $402.99 | $263.85 |
| Austin | $406.53 | $261.64 |
| Bakersfield | $412.54 | $262.45 |
| Baltimore/Surr. Cntys | $418.59 | $271.65 |
| Beaumont | $373.27 | $248.65 |
| Brazoria | $390.15 | $254.44 |
| Chicago | $421.53 | $283.91 |
| Chico | $410.88 | $260.78 |
| Colorado | $407.42 | $261.71 |
| Connecticut | $419.59 | $272.10 |
| Dallas | $392.90 | $256.50 |
| Dc + Md/Va Suburbs | $445.86 | $284.54 |
| Delaware | $391.25 | $255.95 |
| Detroit | $399.98 | $267.83 |
| East St. Louis | $395.85 | $269.86 |
| El Centro | $410.97 | $260.88 |
| Fort Lauderdale | $413.21 | $274.49 |
| Fort Worth | $390.86 | $255.83 |
| Fresno | $410.88 | $260.78 |
| Galveston | $391.50 | $255.52 |
| Hanford-Corcoran | $410.88 | $260.78 |
| Hawaii, Guam | $418.51 | $262.81 |
| Houston | $401.76 | $265.77 |
| Idaho | $367.03 | $241.04 |
| Indiana | $368.87 | $241.92 |
| Iowa | $364.46 | $239.16 |
| Kansas | $363.95 | $240.16 |
| Kentucky | $368.22 | $246.48 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $436.68 | $274.67 |
| Madera | $410.88 | $260.78 |
| Manhattan | $452.54 | $293.41 |
| Merced | $410.88 | $260.78 |
| Metropolitan Boston | $443.41 | $279.90 |
| Metropolitan Kansas City | $380.79 | $252.20 |
| Metropolitan Philadelphia | $410.77 | $268.21 |
| Metropolitan St. Louis | $384.22 | $253.85 |
| Miami | $433.09 | $290.53 |
| Minnesota | $388.58 | $247.67 |
| Mississippi | $358.54 | $240.63 |
| Modesto | $410.88 | $260.78 |
| Montana** | $395.10 | $258.15 |
| Napa | $467.82 | $287.33 |
| Nebraska | $365.93 | $239.53 |
| Nevada** | $392.24 | $255.16 |
| New Hampshire | $402.15 | $259.59 |
| New Mexico | $379.96 | $254.38 |
| New Orleans | $384.22 | $255.35 |
| North Carolina | $373.10 | $245.33 |
| North Dakota** | $384.02 | $247.08 |
| Northern Nj | $442.25 | $283.39 |
| Nyc Suburbs/Long Island | $463.77 | $300.94 |
| Ohio | $375.44 | $250.41 |
| Oklahoma | $366.55 | $244.26 |
| Oxnard-Thousand Oaks-Ventura | $433.75 | $271.89 |
| Portland | $418.04 | $265.89 |
| Poughkpsie/N Nyc Suburbs | $427.41 | $277.45 |
| Puerto Rico | $397.36 | $258.91 |
| Queens | $454.41 | $292.54 |
| Redding | $410.88 | $260.78 |
| Rest Of California | $410.88 | $260.78 |
| Rest Of Florida | $394.50 | $263.59 |
| Rest Of Georgia | $374.09 | $251.93 |
| Rest Of Illinois | $385.82 | $260.79 |
| Rest Of Louisiana | $368.11 | $246.92 |
| Rest Of Maine | $369.81 | $243.82 |
| Rest Of Maryland | $397.82 | $259.23 |
| Rest Of Massachusetts | $405.80 | $261.60 |
| Rest Of Michigan | $377.70 | $252.67 |
| Rest Of Missouri | $363.16 | $245.12 |
| Rest Of New Jersey | $423.87 | $274.32 |
| Rest Of New York | $378.17 | $248.07 |
| Rest Of Oregon | $388.66 | $252.27 |
| Rest Of Pennsylvania | $375.40 | $249.68 |
| Rest Of Texas | $381.68 | $251.72 |
| Rest Of Washington | $404.68 | $260.48 |
| Rhode Island | $403.46 | $262.00 |
| Riverside-San Bernardino-Ontario | $416.95 | $266.86 |
| Sacramento-Roseville-Folsom | $428.98 | $269.71 |
| Salinas | $427.32 | $268.61 |
| San Diego-Chula Vista-Carlsbad | $435.73 | $271.94 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $492.63 | $299.54 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $492.00 | $298.91 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $503.60 | $306.13 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $501.00 | $303.53 |
| San Luis Obispo-Paso Robles | $420.68 | $264.71 |
| Santa Cruz-Watsonville | $438.62 | $272.23 |
| Santa Maria-Santa Barbara | $428.48 | $268.80 |
| Santa Rosa-Petaluma | $442.92 | $274.75 |
| Seattle (King Cnty) | $450.91 | $282.88 |
| South Carolina | $374.99 | $248.45 |
| South Dakota** | $382.71 | $245.77 |
| Southern Maine | $386.18 | $250.47 |
| Stockton | $410.88 | $260.78 |
| Suburban Chicago | $416.77 | $276.13 |
| Tennessee | $365.71 | $241.23 |
| Utah | $379.54 | $250.81 |
| Vallejo | $466.90 | $286.41 |
| Vermont | $383.61 | $248.04 |
| Virgin Islands | $397.36 | $258.91 |
| Virginia | $385.76 | $251.14 |
| Visalia | $410.88 | $260.78 |
| West Virginia | $373.31 | $254.31 |
| Wisconsin | $372.61 | $241.42 |
| Wyoming** | $390.27 | $253.33 |
| Yuba City | $410.88 | $260.78 |
55200 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$353.89
$475.71
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $475.71 | 1 |
| AL | $358.50 | 1 |
| AR | $353.89 | 1 |
| AZ | $385.37 | 1 |
| CA | $410.88–$503.60 | 29 |
| CO | $407.42 | 1 |
| CT | $419.59 | 1 |
| DC | $445.86 | 1 |
| DE | $391.25 | 1 |
| FL | $394.50–$433.09 | 3 |
| GA | $374.09–$402.99 | 2 |
| GU | $418.51 | 1 |
| HI | $418.51 | 1 |
| IA | $364.46 | 1 |
| ID | $367.03 | 1 |
| IL | $385.82–$421.53 | 4 |
| IN | $368.87 | 1 |
| KS | $363.95 | 1 |
| KY | $368.22 | 1 |
| LA | $368.11–$384.22 | 2 |
| MA | $405.80–$443.41 | 2 |
| MD | $397.82–$445.86 | 3 |
| ME | $369.81–$386.18 | 2 |
| MI | $377.70–$399.98 | 2 |
| MN | $388.58 | 1 |
| MO | $363.16–$384.22 | 3 |
| MS | $358.54 | 1 |
| MT | $395.10 | 1 |
| NC | $373.10 | 1 |
| ND | $384.02 | 1 |
| NE | $365.93 | 1 |
| NH | $402.15 | 1 |
| NJ | $423.87–$442.25 | 2 |
| NM | $379.96 | 1 |
| NV | $392.24 | 1 |
| NY | $378.17–$463.77 | 5 |
| OH | $375.44 | 1 |
| OK | $366.55 | 1 |
| OR | $388.66–$418.04 | 2 |
| PA | $375.40–$410.77 | 2 |
| PR | $397.36 | 1 |
| RI | $403.46 | 1 |
| SC | $374.99 | 1 |
| SD | $382.71 | 1 |
| TN | $365.71 | 1 |
| TX | $373.27–$406.53 | 8 |
| UT | $379.54 | 1 |
| VA | $385.76–$445.86 | 2 |
| VI | $397.36 | 1 |
| VT | $383.61 | 1 |
| WA | $404.68–$450.91 | 2 |
| WI | $372.61 | 1 |
| WV | $373.31 | 1 |
| WY | $390.27 | 1 |
How the 55200 rate is calculated
Each of 55200’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 55200
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.44Practice expense 6.83Malpractice 0.56
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 55200
55200 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 55200
Vasotomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 2 | Already bilateral by definition: paid once at 100%. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 55200
Vasotomy
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
55200 without 51 · national office
$395.13
Vasotomy
55200-51 · Second procedure: 50%
$197.57
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
55200 compared with similar codes
Compare codes
55200 vs 55250 vs 55400 vs 74440: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 55250Vasectomy
- Use 55200 for incision into the vas deferens. Use 55250 when the procedure interrupts the duct for sterilization.
- 55400Vasovasostomy
- This code reports vas deferens reconstruction to restore continuity; 55200 reports an incision, not reconnection.
- 74440Vasography
- 74440 reports the radiological supervision and interpretation for vasography, not the surgical incision into the vas deferens.
55200 billing questions
How is 55200 different from vasectomy code 55250?
55200 reports an incision into the vas deferens, such as for duct access. 55250 reports a vasectomy performed to interrupt the duct for sterilization.
Can modifier 50 be used when both sides are treated?
The code is already priced as bilateral. Modifier 50 does not increase payment.
Can vasography imaging be reported with 55200?
When vasography is performed, the radiological supervision and interpretation service may be reported separately with 74440. The operative note should support the vasotomy and the imaging service.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
When can an assistant-at-surgery be paid?
Assistant-at-surgery payment requires documentation that the assistant was medically necessary. Co-surgeons and team surgery are not permitted for this code.
How are other same-session procedures paid?
The highest-valued procedure is paid in full; other procedures in the same session are subject to the standard multiple procedure reduction and are paid at 50%.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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