CPT 89322 · Strict (Kruger) Morphology
89322 is the complete semen analysis graded with strict (Kruger) morphology criteria. It's what most fertility clinics and andrology labs bill, and the line you'll see on the EOB. Here's what it covers and how to get it ordered.
There's no stand-alone CPT code for sperm morphology. Morphology is one part of the semen analysis, and the code changes with how the lab grades it: 89320 for a general differential, 89322 when the lab applies strict Kruger criteria. Order through Hera and we match you to a lab. The physician order is included and the cash price is confirmed before you go.
$60 physician order + the lab's cash price, confirmed before your visit
CPT 89322 is a complete semen analysis — semen volume, sperm count and concentration, motility, and the morphology differential — where the morphology is scored using strict (Kruger) criteria. Under strict criteria a sperm has to be near-perfect in head, midpiece and tail to count as normal, which is why a 'normal' result is 4% or more (WHO 2021) rather than the 30% thresholds of older general grading.
Everything else about the test is identical to CPT 89320. The lab bills 89322 because strict scoring takes longer and needs a trained andrologist. If your report says 'strict morphology', 'Kruger' or 'Tygerberg criteria', 89322 is the code behind it; if it shows a general 'normal forms' percentage, it was probably billed as 89320. There is no separate code for morphology on its own — a lab that runs only morphology still bills a semen analysis code.
1. Place your order with Hera — no lab to choose and no doctor's visit. Tell us where you are and we match you to a lab near you; most labs in our network are fertility-clinic and andrology labs that report strict morphology.
2. Hera's physician signs the order for a complete semen analysis with diagnosis code Z31.41. We send it to the lab and text or email you the location, price and collection instructions within one business day.
3. Upload the report and Hera's AI reads your morphology alongside count, motility and volume against WHO 2021 limits, explains whether a low percentage matters for you, and what to do next.
Submit your order and we match you to a lab that runs the complete analysis. Already have a report with a morphology result? Upload it for a free AI reading.
Order — we'll match you to a lab Upload your morphology resultsEvery lab order carries a CPT code (what the lab runs) and an ICD-10 diagnosis code (why it was ordered). If you bring your own order, or want to check what your insurance will see, these are the codes to look for.
| Code | What it covers |
|---|---|
| 89322 (On a Hera order) | Complete semen analysis — volume, count, motility and morphology scored with strict (Kruger) criteria. What most fertility clinics and andrology labs bill. |
| 89320 | Complete semen analysis with a general morphology differential — the usual code at hospital and reference labs. |
| 89310 | Sperm count and motility only — no morphology reported. |
| 89300 | Sperm presence and motility including the post-coital (Huhner) test — sperm in cervical mucus; rarely ordered today. |
| 89321 | Presence and motility of sperm only — the post-vasectomy check, not a fertility workup. |
| 89331 | Sperm in post-ejaculation urine — ordered when retrograde ejaculation is suspected. |
| 89325 | Anti-sperm antibody test — a separate add-on, not part of the standard analysis. |
| Code | What it covers |
|---|---|
| Z31.41 (On a Hera order) | Encounter for fertility testing — the usual diagnosis code for a first semen analysis. |
| N46.8 | Other male infertility — the usual code once abnormal morphology (teratozoospermia) is documented; teratozoospermia has no code of its own. |
| N46.9 | Male infertility, unspecified — used once infertility is already suspected or being worked up. |
| N46.11 | Organic oligospermia — low sperm count, often reported alongside low morphology. |
Whether a claim says 89320 or 89322 depends on the lab's method, not on what you asked for, and insurers pay both at similar rates when they cover fertility testing at all. Coverage follows the diagnosis code: Z31.41 is often covered inside an infertility workup, but many plans exclude fertility testing outright. Hera confirms the lab's cash price before your visit.
There isn't a stand-alone one. Morphology is billed as part of the semen analysis: CPT 89322 when the lab scores it with strict (Kruger) criteria, CPT 89320 when it reports a general morphology differential. Most fertility clinics and andrology labs bill 89322.
Only the morphology grading. 89322 uses strict Kruger (Tygerberg) criteria, where a sperm must be near-perfect to count as normal and 4% or more is normal. 89320 uses a general differential with a looser normal threshold. Volume, count and motility are measured the same way in both.
89322 is the semen analysis — the lab's version with strict morphology. Labs bill by CPT code, and explanation-of-benefits statements print the code rather than the test name. If you also see 89325 or 89331, those are add-ons for anti-sperm antibodies or retrograde ejaculation.
Z31.41, encounter for fertility testing, for a first analysis. If morphology has already come back low, physicians usually code N46.8, other male infertility (teratozoospermia has no code of its own), or N46.9, male infertility unspecified.
No. A 3% on strict criteria and a 25% on general grading can describe the same sample. Compare results only against the reference range printed on that report, and repeat the test at a lab using the same criteria — ideally the same lab — so the numbers move for real reasons.
Cash prices for a complete semen analysis with strict morphology typically run from about $100 to $300 in the US, usually a little more than 89320 at the same lab. Hera charges a $60 physician-order fee and confirms the lab's price before your visit.