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These services may or may not be covered by your HealthPartners plan. Please see your plan documents for your specific coverage information. If there is a difference between this general information and your plan documents, your plan will be used to determine your coverage.

Administrative process

Prior authorization is not required for vacuum erection systems.

Vacuum erection systems are generally covered subject to the indications listed below and per your plan documents.

Indications that are covered

  1. Vacuum erection system is eligible for coverage for any documented diagnosis of impotence.
  2. Coverage is limited to manual erection device only.
  3. Replacement of constricting bands is covered.

Indications that are not covered

  1. Contraindicated in patients with bleeding disorders or those taking anticoagulants.
  2. Battery-operated devices.

Vacuum erection system - a non-invasive cylinder used to treat men with impotence. The cylinder creates a vacuum, which generates blood flow into the penis allowing the penis to become rigid.

If available, codes are listed below for informational purposes only, and do not guarantee member coverage or provider reimbursement. The list may not be all-inclusive.

L7900 - Male vacuum erection system

CPT Copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.


This item may be received from a contracted specialty provider, such as your urologist, or from a contracted DME vendor.


This information is for most, but not all, HealthPartners plans. Please read your plan documents to see if your plan has limits or will not cover some items. If there is a difference between this general information and your plan documents, your plan documents will be used to determine your coverage. These coverage criteria may not apply to Medicare Products if Medicare requires different coverage. For more information regarding Medicare coverage criteria or for a copy of a Medicare coverage policy, contact Member Services at 952-883-7979 or 1-800-233-9645.

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Policy activity

  • 1/01/1994 - Date of origin
  • 1/01/1994 - Effective date
Reviews & revisions
  • 8/2015
Policy number
  • D010-05

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