CPT code 53866: Device removal, ischemic remodeling2026 Medicare rate & RVUs
Report cystoscopic removal of a temporary prostate remodeling device after treatment for urinary obstruction associated with benign prostatic enlargement.
Medicare pays $145.63 for 53866 nationally in the office and $73.82 in a hospital or facility. Local office rates run $129.69–$188.28.
Medicare rate · 53866
Device removal, ischemic remodeling
- Work RVUs
- 1.44
- Total RVUs
- 4.36
- Global days
- 000
National rate · 2026
$145.63
Office setting, before claim adjustments.
See every locality for 53866 →Billed by an NP, PA or therapist? →
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 10 sections
What 53866 covers
A urologist uses cystoscopy to retrieve the temporary device previously placed to remodel the prostatic urethra through ischemic effects. The treatment is used for urinary symptoms associated with benign prostatic enlargement; this code describes the removal service, not initial device placement. Removal is generally performed in an outpatient setting after the device has served its intended remodeling purpose.
Report the removal code for the cystoscopic retrieval, supported by documentation identifying the device and recording its removal. Code 53865 describes placement of the device. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing 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 53866 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$129.69 to $188.28
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $131.48 | $68.64 |
| Alaska | $172.75 | $96.27 |
| Arizona | $141.89 | $72.30 |
| Arkansas | $129.69 | $68.01 |
| Atlanta, GA | $148.51 | $75.55 |
| Austin, TX | $150.29 | $74.31 |
| Bakersfield, CA | $152.81 | $74.11 |
| Baltimore area, MD | $154.56 | $77.50 |
| Beaumont, TX | $136.97 | $71.62 |
| Brazoria, TX | $143.80 | $72.63 |
| Chicago, IL | $154.64 | $82.47 |
| Chico, CA | $152.25 | $73.55 |
| Colorado | $150.65 | $74.24 |
| Connecticut | $154.94 | $77.60 |
| Dallas, TX | $144.79 | $73.27 |
| Delaware | $144.13 | $73.18 |
| Detroit, MI | $146.79 | $77.49 |
| East St. Louis, IL | $144.77 | $78.70 |
| El Centro, CA | $152.29 | $73.58 |
| Fort Lauderdale, FL | $151.94 | $79.20 |
| Fort Worth, TX | $143.97 | $73.16 |
| Fresno, CA | $152.25 | $73.55 |
| Galveston, TX | $144.28 | $72.97 |
| Hanford, CA | $152.25 | $73.55 |
| Hawaii, Guam, HI | $155.45 | $73.80 |
| Houston, TX | $147.76 | $76.45 |
| Idaho | $134.99 | $68.92 |
| Indiana | $135.71 | $69.14 |
| Iowa | $134.05 | $68.34 |
| Kansas | $133.73 | $68.81 |
| Kentucky | $134.97 | $71.13 |
| King County, WA | $167.57 | $79.46 |
| Los Angeles, CA | $162.15 | $77.20 |
| Madera, CA | $152.25 | $73.55 |
| Manhattan, NY | $167.20 | $83.75 |
| Marin County, CA | $184.15 | $82.89 |
| Merced, CA | $152.25 | $73.55 |
| Metropolitan Boston, MA | $164.59 | $78.85 |
| Metropolitan Kansas City, MO | $139.92 | $72.49 |
| Metropolitan Philadelphia, PA | $151.46 | $76.70 |
| Metropolitan St. Louis, MO | $141.26 | $72.90 |
| Miami, FL | $159.07 | $84.31 |
| Minnesota | $143.80 | $69.91 |
| Mississippi | $131.30 | $69.47 |
| Modesto, CA | $152.25 | $73.55 |
| Montana | $145.62 | $73.80 |
| Napa, CA | $174.53 | $79.88 |
| Nebraska | $134.66 | $68.38 |
| Nevada | $144.66 | $72.78 |
| New Hampshire | $148.57 | $73.82 |
| New Mexico | $139.34 | $73.48 |
| New Orleans, LA | $141.11 | $73.54 |
| North Carolina | $137.23 | $70.23 |
| North Dakota | $141.86 | $70.05 |
| Northern New Jersey | $163.68 | $80.38 |
| NYC suburbs and Long Island, NY | $171.38 | $85.99 |
| Ohio | $137.75 | $72.18 |
| Oklahoma | $134.46 | $70.33 |
| Oxnard, CA | $161.18 | $76.30 |
| Portland, OR | $154.89 | $75.11 |
| Poughkeepsie and northern NYC suburbs, NY | $157.79 | $79.15 |
| Puerto Rico | $146.54 | $73.93 |
| Queens, NY | $168.11 | $83.23 |
| Redding, CA | $152.25 | $73.55 |
| Rest of California | $152.25 | $73.55 |
| Rest of Florida | $144.81 | $76.16 |
| Rest of Georgia | $137.00 | $72.94 |
| Rest of Illinois | $141.27 | $75.70 |
| Rest of Louisiana | $134.88 | $71.32 |
| Rest of Maine | $135.93 | $69.87 |
| Rest of Maryland | $146.68 | $74.01 |
| Rest of Massachusetts | $149.94 | $74.32 |
| Rest of Michigan | $138.51 | $72.95 |
| Rest of Missouri | $132.88 | $70.98 |
| Rest of New Jersey | $156.56 | $78.14 |
| Rest of New York | $139.18 | $70.96 |
| Rest of Oregon | $143.38 | $71.85 |
| Rest of Pennsylvania | $137.80 | $71.88 |
| Rest of Texas | $140.36 | $72.21 |
| Rest of Washington | $149.57 | $73.95 |
| Rhode Island | $148.87 | $74.68 |
| Riverside, CA | $154.31 | $75.61 |
| Sacramento, CA | $159.28 | $75.76 |
| Salinas, CA | $158.67 | $75.44 |
| San Benito County, CA | $188.28 | $84.72 |
| San Diego, CA | $162.04 | $76.15 |
| San Francisco, CA | $183.93 | $82.68 |
| San Luis Obispo, CA | $156.18 | $74.38 |
| Santa Clara County, CA | $187.40 | $83.84 |
| Santa Cruz, CA | $163.30 | $76.05 |
| Santa Maria, CA | $159.17 | $75.43 |
| Santa Rosa, CA | $164.92 | $76.73 |
| South Carolina | $137.75 | $71.39 |
| South Dakota | $141.41 | $69.60 |
| Southern Maine, ME | $142.47 | $71.30 |
| Stockton, CA | $152.25 | $73.55 |
| Suburban Chicago, IL | $153.33 | $79.57 |
| Tennessee | $134.39 | $69.11 |
| Utah | $139.51 | $72.01 |
| Vallejo, CA | $174.22 | $79.57 |
| Vermont | $141.58 | $70.49 |
| Virgin Islands, VI | $146.54 | $73.93 |
| Virginia | $142.21 | $71.62 |
| Visalia, CA | $152.25 | $73.55 |
| Washington, DC area | $165.17 | $80.58 |
| West Virginia | $136.42 | $74.01 |
| Wisconsin | $137.41 | $68.61 |
| Wyoming | $143.98 | $72.17 |
| Yuba City, CA | $152.25 | $73.55 |
53866 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$129.69
$172.75
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $172.75 | 1 |
| AL | $131.48 | 1 |
| AR | $129.69 | 1 |
| AZ | $141.89 | 1 |
| CA | $152.25–$188.28 | 29 |
| CO | $150.65 | 1 |
| CT | $154.94 | 1 |
| DC | $165.17 | 1 |
| DE | $144.13 | 1 |
| FL | $144.81–$159.07 | 3 |
| GA | $137.00–$148.51 | 2 |
| GU | $155.45 | 1 |
| HI | $155.45 | 1 |
| IA | $134.05 | 1 |
| ID | $134.99 | 1 |
| IL | $141.27–$154.64 | 4 |
| IN | $135.71 | 1 |
| KS | $133.73 | 1 |
| KY | $134.97 | 1 |
| LA | $134.88–$141.11 | 2 |
| MA | $149.94–$164.59 | 2 |
| MD | $146.68–$165.17 | 3 |
| ME | $135.93–$142.47 | 2 |
| MI | $138.51–$146.79 | 2 |
| MN | $143.80 | 1 |
| MO | $132.88–$141.26 | 3 |
| MS | $131.30 | 1 |
| MT | $145.62 | 1 |
| NC | $137.23 | 1 |
| ND | $141.86 | 1 |
| NE | $134.66 | 1 |
| NH | $148.57 | 1 |
| NJ | $156.56–$163.68 | 2 |
| NM | $139.34 | 1 |
| NV | $144.66 | 1 |
| NY | $139.18–$171.38 | 5 |
| OH | $137.75 | 1 |
| OK | $134.46 | 1 |
| OR | $143.38–$154.89 | 2 |
| PA | $137.80–$151.46 | 2 |
| PR | $146.54 | 1 |
| RI | $148.87 | 1 |
| SC | $137.75 | 1 |
| SD | $141.41 | 1 |
| TN | $134.39 | 1 |
| TX | $136.97–$150.29 | 8 |
| UT | $139.51 | 1 |
| VA | $142.21–$165.17 | 2 |
| VI | $146.54 | 1 |
| VT | $141.58 | 1 |
| WA | $149.57–$167.57 | 2 |
| WI | $137.41 | 1 |
| WV | $136.42 | 1 |
| WY | $143.98 | 1 |
How the 53866 rate is calculated
Each of 53866’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 · 53866
RVUs × geographic indexes × conversion factor
Work1.44
1.44 RVUs× 1.000 GPCI
Practice expense2.73
2.73 RVUs× 1.000 GPCI
Malpractice0.19
0.19 RVUs× 1.000 GPCI
Adjusted RVUs
4.3600
Conversion factor
$33.4009
Medicare rate
$145.63
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 53866
The CMS indicators that decide how 53866 is paid alongside other services.
CMS payment indicators · 53866
Device removal, ischemic remodeling
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
53866 without 51 · national office
$145.63
Device removal, ischemic remodeling
53866-51 · Second procedure: 50%
$72.82
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%).
53866 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 53865Prostate remodelingTemporary implant insertion
- Use 53865 for cystoscopic placement of the temporary remodeling device; use 53866 for its removal.
- 53850Prostate treatmentMicrowave thermotherapy
- This code describes removal of a remodeling device. Code 53850 represents microwave thermotherapy of prostate tissue.
- 53854Prostate ablationRadiofrequency water vapor
- This code covers cystoscopic device retrieval; 53854 describes prostate tissue treatment using radiofrequency-generated water vapor.
53866 billing questions
How does this code differ from 53865?
53866 is for cystoscopic retrieval of the prostate remodeling device. 53865 describes its placement.
Can the removal be reported with another procedure on the same date?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction.
Should modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this code.
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.
What documentation supports the removal service?
Document the temporary remodeling device and its cystoscopic retrieval. The record should distinguish removal from the device's initial placement.
What care is included in the global period?
The 0-day global period includes same-day preoperative and postoperative care.
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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