Billing code 55250: VasectomyMedicare rate & RVUs in Ohio
A vasectomy interrupts both vas deferens for permanent male contraception, with postoperative semen examinations included in the service.
Medicare pays $327.43 for 55250 in the office in Ohio (Ohio). Which amount applies depends on the service address.
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 8 sections
What 55250 covers
55250 represents surgical interruption of both vas deferens to provide permanent contraception. A urologist typically performs the procedure in an office or ambulatory surgery setting, commonly with local anesthesia. The service includes postoperative semen examinations used to assess for sperm after the procedure. It is selected for vas deferens interruption, rather than an incision performed for another purpose or surgery to restore duct continuity.
Report the operation once; CMS pricing already accounts for bilateral treatment, so modifier 50 does not increase payment. Documentation should support the contraception indication and record the operative treatment of both ducts. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When another procedure is performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery services are not paid; 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.
55250 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | $327.43 | $210.03 |
How the 55250 rate is calculated
Each of 55250’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 · 55250
RVUs × geographic indexes × conversion factor
Work3.29
3.29 RVUs× 1.000 GPCI
Practice expense6.67
6.67 RVUs× 1.000 GPCI
Malpractice0.42
0.42 RVUs× 1.000 GPCI
Adjusted RVUs
10.3800
Conversion factor
$33.4009
Medicare rate
$346.70
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 55250
55250 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 55250
Vasectomy
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 55250
Vasectomy
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
55250 without 51 · national office
$346.70
Vasectomy
55250-51 · Second procedure: 50%
$173.35
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%).
55250 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 55200Vasotomy
- 55200 represents an incision of the vas deferens. Use 55250 when the purpose is permanent contraception through interruption of both ducts.
- 55400Vasovasostomy
- 55400 is used for vas deferens reconstruction to restore continuity, such as after a prior vasectomy; 55250 is the interruption procedure.
- 89310Semen analysis w/count
- 89310 is a semen analysis service. Postoperative semen examinations associated with 55250 are included in the vasectomy service.
55250 billing questions
Should modifier 50 be appended?
No. CMS prices 55250 as bilateral, and modifier 50 does not increase payment.
Are postoperative semen examinations included?
Yes. The service includes postoperative semen examinations related to assessing the vasectomy result.
What does the 90-day global period include?
It includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services are not paid for this code. CMS also does not permit co-surgeons or team surgery.
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
Fee sheets
Put 55250 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →