Post Op: Right varicocele with vasitis and spermatocele, epididymitis, chronic.

Description: A median raphe incision was made through the skin down to the layers of the skin down to the tunica vaginalis. The tunica vaginalis was incised as well as detachment of the gubernacular attachments was performed. Once the testicle is freed up, the tunica vaginalis was opened with clear fluid. The majority of the inflammatory changes appeared to be where his vasectomy was, and the vas deferens was freed up form his spermatic cord using sharp and blunt dissection beginning at the abdominal side to remove the vasoligation what appeared to be possible even sperm granuloma. The vas deferens was dissected all the way back to the head of the epididymis and transected an ligated with a 2-0 Vicryl. Numerous large dilated veins were seen crossing through the spermatic cord. We ligated with a 2-0 Vicrl. The spermatic cord was anesthetized with 1% lidocaine and irrigation was performed. The testicle was placed back into the right hemiscrotum. Two-layer closure with 2-0 running Vicryl was performed.

The physician states in procedures Right epididymectomy with vasectomy and ligation of varicocele. The patient did have a vasectomy prior to this. Should the vasectomy be charged for? Thank You