Fee Navigator®

    Health Service Code 75.64

    Vasectomy (complete) (partial)

    NOTE:

    May not be claimed if vasectomy is subsequent to a previous reversal. If a repeat procedure is required due to a previously failed attempt, supporting documentation must be provided.

    Category:14 Major Procedure (pre-operative period: 30 days, post-operative period: 14 days)
    Base rate:$184.30

    AMA billing tips:

    • If a patient previously had an insured vasectomy followed by a reversal, the second vasectomy is not considered to be an insured service and should be billed to the patient.

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIANTYesIncrease By25%
    BMIBMIPROYesIncrease By25%
    ROLEANEYesReplace Base$112.39
    ROLEANESTYesReplace Base$18.70
    ANUANU1For Each Call Pay Base At100%
    ANUANU2 - 150For Each Call Increase By$18.70
    TRAYMAJTIncrease By$38.88
    NBTRNBTRYes
    SURCEVYesIncrease By$48.82
    SURCNTAMYesIncrease By$117.12
    SURCNTPMYesIncrease By$117.12
    SURCWKYesIncrease By$48.82
    LVPLVP75YesReduce Base To75%

    Governing Rules: