No office rate
Use 54901 when the vas-to-epididymis reconstruction is performed with microsurgical technique; 54900 represents the corresponding procedure without that technique.
On this page
CMS RVU26D · Effective 2026-10-01
54900 Duct reconstruction Medicare reimbursement rates in Vermont
Reports surgical connection of the vas deferens to an epididymal duct to bypass obstruction and restore sperm passage in selected patients. Compare 54900 office and facility rates across CMS payment localities in Vermont.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 54900 in Vermont?
Vermont has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$693.56
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Urology surgery
About 54900: Vasoepididymal anastomosis
Reports surgical connection of the vas deferens to an epididymal duct to bypass obstruction and restore sperm passage in selected patients.
A urologist uses this procedure to connect the vas deferens to an epididymal duct, bypassing an obstruction that prevents sperm from entering the vas. It may be considered in obstructive infertility when a direct connection between the two ends of the vas deferens is not suitable. The operation is performed in a surgical setting, commonly under anesthesia, and requires identification of a suitable epididymal tubule and the obstructed vasal segment.
Select this code for the vas-to-epididymis connection, rather than a vasovasostomy that joins the cut ends of the vas deferens. Document the obstructive anatomy, operative findings, and reconstruction performed; the descriptor covers unilateral or bilateral work, so modifier 50 is inappropriate. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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 multiple-procedure reduction. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 54900
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU13.85 · 64%
- Practice expense (office) RVU6.08 · 28%
- Malpractice RVU1.77 · 8%
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.
54900 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
Use 55400 for joining the cut ends of the vas deferens. Use 54900 when the reconstruction instead connects the vas deferens to an epididymal duct.
Compare 54900 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Vermont →
Office / nonfacility
Unavailable
Facility
$693.56
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 54900 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
6,334
- Code
- 54900
- Physician work
- 13.85
- Practice expense
- 6.08
- Malpractice
- 1.77
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.85 | × 1.000 | 13.8500 |
| Practice expense | 6.08 | × 0.990 | 6.0192 |
| Malpractice | 1.77 | × 0.506 | 0.8956 |
| Total RVUs | 20.7648 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$693.56
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.85 | 1 |
| Practice expense | 6.08 | 0.99 |
| Malpractice | 1.77 | 0.506 |
(13.85 × 1 + 6.08 × 0.99 + 1.77 × 0.506) × $33.4009 = $693.56
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
54900 billing questions
How is this different from a vasovasostomy?
This procedure connects the vas deferens to an epididymal duct to bypass an obstruction. A vasovasostomy joins the cut ends of the vas deferens when that direct repair is suitable.
Can I report this code for both sides?
Yes. The descriptor includes unilateral or bilateral work, and modifier 50 is inappropriate.
What documentation supports the code?
Record the obstructed anatomy, operative findings, and the connection made between the vas deferens and an epididymal duct.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeons and team surgery are not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
6,33154860,,Removal of epididymis,A,,6.78,3.95,NA,3.95,,0.88,11.61,11.61,0,090,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,33254861,,Removal of epididymis,A,,9.46,4.89,NA,4.89,,1.22,15.57,15.57,0,090,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,33354865,,Explore epididymis,A,,5.63,3.71,NA,3.71,,0.72,10.06,10.06,0,090,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,33454900,,Fusion of spermatic ducts,A,,13.85,6.08,NA,6.08,,1.77,21.70,21.70,0,090,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,33554901,,Fusion of spermatic ducts,A,,18.62,7.46,NA,7.46,,2.40,28.48,28.48,0,090,0.10,0.80,0.10,2,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,33655000,,Drainage of hydrocele,A,,1.39,2.21,,0.74,,0.18,3.78,2.31,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,33755040,,Removal of hydrocele,A,,5.31,3.41,NA,3.41,,0.71,9.43,9.43,0,090,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817