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Vasectomy: what insurers pay

Male sterilization. Commercial negotiated rates by hospital and market, next to Medicare for the same code.

Open the interactive explorerAll operations

CPT 55250: Vasectomy

1175 hospitals in 79 markets. National Medicare rate $2,136, surgery center $1,002.

MarketHospitals25th pctMedian75th pctLow–high
Alabama (statewide)14$2,281$2,910$3,601$1,052–$6,571
Alaska (statewide)3———$2,394–$11,439
Arizona (statewide)11$2,596$2,986$3,814$1,336–$6,628
Arkansas (statewide)8$1,708$1,834$1,862$1,472–$2,831
Atlanta GA6$4,175$4,175$4,579$4,175–$4,714
Austin TX13$1,701$3,322$4,836$1,701–$4,863
Boston MA16$1,990$3,234$3,458$1,748–$4,371
California (statewide)61$4,199$6,044$7,752$1,838–$11,383
Charlotte NC5$2,435$2,435$2,435$2,402–$2,435
Chicago IL10$3,337$4,109$6,168$2,125–$7,295
Cleveland OH11$3,035$3,502$3,720$1,857–$4,757
Colorado (statewide)17$2,752$4,149$5,105$1,416–$7,895
Connecticut (statewide)2———$2,779–$3,362
Dallas-Fort Worth TX12$4,182$4,807$4,916$3,860–$8,913
Delaware (statewide)1———$5,681–$5,681
Denver CO15$2,404$5,105$5,396$1,416–$6,170
Detroit MI13$2,577$3,273$3,273$1,133–$5,812
Florida (statewide)59$3,645$4,578$5,738$1,464–$8,690
Georgia (statewide)30$2,836$4,423$4,714$1,750–$14,666
Hawaii (statewide)3———$2,550–$3,915
Houston TX19$3,654$3,990$4,052$2,831–$4,151
Idaho (statewide)13$2,166$3,506$5,203$1,298–$6,171
Illinois (statewide)27$2,952$3,523$4,870$1,567–$7,295
Indiana (statewide)30$2,245$3,386$6,099$1,263–$8,220
Iowa (statewide)29$2,568$3,079$3,600$1,158–$6,621
Kansas (statewide)27$2,192$2,433$3,535$1,138–$11,439
Kentucky (statewide)15$2,513$2,775$3,360$1,788–$3,721
Las Vegas NV1———$3,010–$3,010
Los Angeles CA17$3,898$5,204$5,729$3,747–$14,342
Louisiana (statewide)23$2,232$3,112$4,062$1,580–$6,042
Maine (statewide)17$8,394$9,425$9,745$2,214–$12,252
Maryland (statewide)1———$987–$987
Massachusetts (statewide)9$2,494$3,380$3,542$1,930–$3,623
Miami-Fort Lauderdale FL1———$3,825–$3,825
Michigan (statewide)26$1,726$1,984$2,296$1,168–$3,273
Minneapolis-St. Paul MN8$3,960$4,149$4,168$2,004–$4,686
Minnesota (statewide)12$4,561$5,493$6,715$3,079–$16,771
Mississippi (statewide)17$2,547$3,006$3,519$1,249–$5,701
Missouri (statewide)17$2,845$3,708$4,624$1,290–$6,897
Montana (statewide)5$4,302$4,728$5,980$4,146–$6,052
Nashville TN7$2,399$2,399$3,752$2,399–$4,292
Nebraska (statewide)13$3,376$3,666$4,233$1,254–$6,799
Nevada (statewide)2———$3,979–$5,320
New Hampshire (statewide)6$3,756$5,224$6,720$2,265–$9,361
New Jersey (statewide)21$2,377$6,602$7,770$2,377–$9,421
New Mexico (statewide)8$3,442$4,232$7,221$1,532–$12,650
New York (statewide)33$2,848$3,729$4,604$1,416–$7,725
New York City7$2,922$2,926$6,465$2,907–$8,434
North Carolina (statewide)6$4,240$5,178$5,451$1,884–$9,044
North Dakota (statewide)5$3,597$3,712$4,654$3,544–$6,540
Ohio (statewide)40$3,691$4,684$6,123$1,786–$8,034
Oklahoma (statewide)9$4,258$4,624$6,886$2,682–$10,412
Oregon (statewide)12$3,773$5,246$7,190$1,682–$9,496
Pennsylvania (statewide)39$2,548$4,201$6,518$1,088–$9,244
Philadelphia PA11$3,452$3,602$5,201$3,296–$8,282
Phoenix AZ8$2,876$3,004$3,039$2,600–$3,039
Pittsburgh PA8$2,613$3,223$4,242$2,428–$5,156
Portland OR9$6,073$6,073$8,673$6,058–$8,673
Research Triangle NC1———$2,239–$2,239
Rhode Island (statewide)6$2,868$3,840$4,774$2,055–$6,502
Richmond VA3———$4,934–$5,051
Rio Grande Valley TX5$2,716$2,780$4,807$2,716–$4,889
Salt Lake City UT9$4,173$4,976$4,976$1,854–$4,976
San Antonio TX3———$3,150–$4,590
San Diego CA7$4,668$4,705$4,705$3,845–$4,958
San Francisco Bay Area CA6$5,246$5,504$6,002$3,690–$19,507
Seattle-Tacoma WA16$5,920$6,076$6,346$5,446–$7,354
South Carolina (statewide)28$6,851$8,732$10,425$3,818–$11,594
South Dakota (statewide)6$2,991$3,202$3,495$2,532–$10,502
Tampa FL6$6,291$6,291$6,291$3,106–$9,268
Tennessee (statewide)32$2,133$2,458$3,124$1,811–$4,456
Texas (statewide)77$2,520$3,990$4,807$1,604–$8,220
Utah (statewide)7$2,378$4,976$5,779$1,854–$7,067
Vermont (statewide)1———$2,846–$2,846
Virginia (statewide)20$4,280$5,820$7,013$3,046–$10,053
Washington (statewide)14$4,560$5,654$6,482$2,088–$9,970
Washington DC9$3,488$3,645$3,645$3,273–$4,046
West Virginia (statewide)8$3,492$5,158$7,192$2,274–$13,917
Wisconsin (statewide)43$4,625$6,026$6,825$1,316–$9,046

Lowest and highest 12 hospital medians

HospitalMarketMedian across insurers× MedicareInsurersFile date
Atlantic General HospitalMaryland (statewide)$9870.5×12026-04-10
Usa Health University HospitalAlabama (statewide)$1,0520.6×12026-04-30
Robert Packer HospitalPennsylvania (statewide)$1,0880.5×92026-03-31
Troy Community HospitalPennsylvania (statewide)$1,0880.5×72026-03-31
Henry Ford Health -St John HospitalDetroit MI$1,1330.5×12026-01-01
Ellsworth County Medical CenterKansas (statewide)$1,1380.6×22026-08-04
Boone County HospitalIowa (statewide)$1,1580.6×12026-07-27
Oaklawn HospitalMichigan (statewide)$1,1680.6×22026-03-27
Greene County HospitalMississippi (statewide)$1,2490.7×12026-06-05
Chi Health PlainviewNebraska (statewide)$1,2540.6×12026-02-28
Pulaski Memorial HospitalIndiana (statewide)$1,2630.6×62026-07-07
Columbus Regional HospitalIndiana (statewide)$1,2840.6×12026-04-01
Prisma Health Richland HospitalSouth Carolina (statewide)$11,5945.7×22026-03-01
Prisma Health Baptist ParkridgeSouth Carolina (statewide)$11,5945.7×22026-03-01
Mainehealth Lincoln HospitalMaine (statewide)$12,2526.0×12025-09-09
Los Alamos Medical CenterNew Mexico (statewide)$12,6506.1×12026-07-10
Northeast Georgia Medical Center, IncGeorgia (statewide)$12,8906.4×12026-04-01
Northeast Georgia Medical Center HabershamGeorgia (statewide)$12,8907.0×12026-04-01
Logan Regional Medical CenterWest Virginia (statewide)$13,9176.9×12026-04-01
Cedars-Sinai Medical CenterLos Angeles CA$14,3425.3×32025-11-26
Northeast Georgia Medical Center BarrowGeorgia (statewide)$14,6667.0×22026-04-01
Northeast Georgia Medical Center LumpkinGeorgia (statewide)$14,6667.0×22026-04-01
Grand Itasca Clinic And HospitalMinnesota (statewide)$16,7717.8×12026-01-28
Stanford Health CareSan Francisco Bay Area CA$19,5076.3×42026-04-01

Every hospital is on its state's page (linked in the market table) and in the interactive explorer.

Questions

How much do commercial insurers pay hospitals for vasectomy?

Across 1175 hospitals in 79 markets (metro areas and statewide) that post a usable dollar rate, the median commercial rate for CPT 55250, hospital outpatient is $4,038, 1.9× the same hospital's local Medicare base rate. The middle half of hospitals runs $2,806 to $5,699. Figures are each hospital's median across insurers, from its federal price-transparency file.

What does Medicare pay for vasectomy?

Medicare's national hospital outpatient rate for CPT 55250 is $2,136 and its surgery-center rate is $1,002, before local wage adjustment.

Which hospitals post the lowest and highest commercial rates for vasectomy?

Lowest medians: Atlantic General Hospital ($987), Usa Health University Hospital ($1,052), Robert Packer Hospital ($1,088). Highest: Stanford Health Care ($19,507), Grand Itasca Clinic And Hospital ($16,771), Northeast Georgia Medical Center Lumpkin ($14,666). Coverage: every hospital whose price file we could read.