No office rate
Choose 55400 for reconnection of the vas deferens. Choose 54900 when the surgeon connects the epididymis to the vas to bypass an epididymal obstruction.
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CMS RVU26D · Effective 2026-10-01
55400 Vasovasostomy Medicare reimbursement rates in Vermont
Microsurgical reconnection of the vas deferens restores a pathway for sperm after vasectomy or another interruption of the duct. Compare 55400 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 55400 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
$437.37
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.
Male reproductive surgery
About 55400: Vas deferens reconnection after vasectomy
Microsurgical reconnection of the vas deferens restores a pathway for sperm after vasectomy or another interruption of the duct.
A vasovasostomy reconnects the divided ends of the vas deferens so sperm can pass into the ejaculate. A urologist typically performs the operation in an operating room, often using magnification to align the small duct openings. It is commonly considered for a patient seeking fertility after vasectomy; the operative findings determine whether the vasal ends can be rejoined.
Report the service for the documented reconstruction, identifying the treated side or sides and the reason for the repair. The operative report should describe the vasal findings and the repair performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For bilateral reporting with modifier 50, CMS pays 150%. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 55400
- 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.39 · 61%
- Practice expense (office) RVU4.20 · 31%
- Malpractice RVU1.08 · 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.
55400 compared with similar codes
Office rates for Vermont, from the same CMS release.
$337.54
55250 is vasectomy for sterilization; 55400 reconstructs the vas deferens to restore sperm passage, commonly after vasectomy.
Compare 55400 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
$437.37
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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 55400 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
6,349
- Code
- 55400
- Physician work
- 8.39
- Practice expense
- 4.20
- Malpractice
- 1.08
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.39 | × 1.000 | 8.3900 |
| Practice expense | 4.20 | × 0.990 | 4.1580 |
| Malpractice | 1.08 | × 0.506 | 0.5465 |
| Total RVUs | 13.0945 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$437.37
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.39 | 1 |
| Practice expense | 4.2 | 0.99 |
| Malpractice | 1.08 | 0.506 |
(8.39 × 1 + 4.2 × 0.99 + 1.08 × 0.506) × $33.4009 = $437.37
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.
55400 billing questions
When is vasovasostomy the appropriate repair?
Use it when the surgeon reconnects the vas deferens, commonly to restore sperm passage after vasectomy. If the obstruction is in the epididymis and the surgeon creates an epididymal-to-vas connection, consider 54900 instead.
Does the 90-day global period include routine postoperative care?
Yes. CMS includes the day-before preoperative visit and related postoperative care for 90 days in the global period.
How is bilateral repair reported under the CMS facts?
Report bilateral repair with modifier 50. CMS pays the bilateral service at 150%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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.
6,34655200,,Incision of sperm duct,A,,4.44,6.83,,2.73,,0.56,11.83,7.73,0,090,0.10,0.80,0.10,2,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,34755250,,Removal of sperm duct(s),A,,3.29,6.67,,2.82,,0.42,10.38,6.53,0,090,0.10,0.80,0.10,2,2,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,34855300,,Prepare sperm duct x-ray,A,,3.41,1.10,NA,1.10,,0.43,4.94,4.94,0,000,0.00,0.00,0.00,2,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,34955400,,Repair of sperm duct,A,,8.39,4.20,NA,4.20,,1.08,13.67,13.67,0,090,0.10,0.80,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,35055500,,Removal of hydrocele,A,,6.06,4.02,NA,4.02,,0.93,11.01,11.01,0,090,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,35155520,,Removal of sperm cord lesion,A,,6.49,5.33,NA,5.33,,1.64,13.46,13.46,0,090,0.10,0.80,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,35255530,,Revise spermatic cord veins,A,,5.61,3.44,NA,3.44,,0.73,9.78,9.78,0,090,0.10,0.80,0.10,2,1,1,1,0,9,,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