CPT code 53854: Prostate ablation, radiofrequency water vapor2026 Medicare rate & RVUs in Maryland
Reports transurethral treatment of benign prostatic obstruction using radiofrequency-generated water vapor to ablate prostate tissue and relieve urinary symptoms.
Medicare pays $3,433.54–$3,974.37 for 53854 in the office in Maryland, from Rest of Maryland to Washington, DC area. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 53854 covers
A urologist uses a transurethral endoscopic approach to deliver radiofrequency-generated water vapor into prostate tissue. The resulting thermal injury treats benign prostatic enlargement that contributes to lower urinary tract symptoms, such as difficulty emptying the bladder or a weak urinary stream. The service is commonly performed in an outpatient setting, including an office or a hospital or ambulatory surgery facility.
Select this code when the documented prostate tissue treatment uses the water-vapor method, rather than microwave or another radiofrequency technique. The operative record should identify the indication, approach, and treatment method. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery reporting are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 53854 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$3433.54 to $3974.37
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | $3,636.51 | $373.00 |
| Rest of Maryland | $3,433.54 | $355.56 |
| Washington, DC area | $3,974.37 | $391.50 |
How the 53854 rate is calculated
Each of 53854’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 53854
RVUs × geographic indexes × conversion factor
Work5.78
5.78 RVUs× 1.000 GPCI
Practice expense95.13
95.13 RVUs× 1.000 GPCI
Malpractice0.75
0.75 RVUs× 1.000 GPCI
Adjusted RVUs
101.6600
Conversion factor
$33.4009
Medicare rate
$3,395.54
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 53854
53854 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 53854
Prostate ablation, radiofrequency water vapor
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.08/0.83/0.09 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 53854
Prostate ablation, radiofrequency water vapor
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
53854 without 51 · national office
$3,395.54
Prostate ablation, radiofrequency water vapor
53854-51 · Second procedure: 50%
$1,697.77
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
53854 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 53850Prostate treatmentMicrowave thermotherapy
- Choose 53850 when microwave thermotherapy is used. This code is for radiofrequency-generated water vapor.
- 53852Prostate ablationRadiofrequency thermotherapy
- Choose 53852 for radiofrequency thermotherapy that is not the water-vapor method. The treatment technology documented in the operative report separates the codes.
- 52601TURPElectrosurgical resection
- Code 52601 represents transurethral resection of prostate tissue. This code represents water-vapor thermal ablation, not resection.
- 52441Prostate implantFirst implant
- Code 52441 represents placement of a prostatic urethral lift implant. This code is used when prostate tissue is treated with water-vapor thermal energy instead.
53854 billing questions
How is this code distinguished from 53850 or 53852?
Use this code for radiofrequency-generated water-vapor treatment. Code 53850 identifies microwave treatment, while 53852 identifies radiofrequency thermotherapy without the water-vapor method.
Can routine endoscopic access be billed separately?
Do not assume that routine access or guidance during the prostate treatment is a separate service. A separately reported service must be distinct and supported by the operative documentation.
Should modifier 50 be reported for treatment of both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days after surgery.
How are other same-session procedures paid?
When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and the other procedures at 50%.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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