CPT code 53866: Device removal, ischemic remodeling2026 Medicare rate & RVUs in Washington, DC area
Report cystoscopic removal of a temporary prostate remodeling device after treatment for urinary obstruction associated with benign prostatic enlargement.
In Washington, DC area, Medicare pays $165.17 for 53866 in the office and $80.58 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 53866 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 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.
How Washington, DC area compares for 53866
Across 109 of 109 payment localities, the office rate for 53866 runs from $129.69 in Arkansas to $188.28 in San Benito County, CA. Washington, DC area pays $165.17. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Washington, DC area · this page$165.17
- Los Angeles, CA · California$162.15−$3.02
- Miami, FL · Florida$159.07−$6.10
- Chicago, IL · Illinois$154.64−$10.53
- Manhattan, NY · New York$167.20+$2.03
- Alaska · Alaska$172.75+$7.58
- Alabama · Alabama$131.48−$33.69
Other areas in District of Columbia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| ArkansasArkansas | $129.69 | $68.01 |
| ArizonaArizona | $141.89 | $72.30 |
| Bakersfield, CACalifornia | $152.81 | $74.11 |
| Chico, CACalifornia | $152.25 | $73.55 |
| El Centro, CACalifornia | $152.29 | $73.58 |
| Fresno, CACalifornia | $152.25 | $73.55 |
| Hanford, CACalifornia | $152.25 | $73.55 |
| Madera, CACalifornia | $152.25 | $73.55 |
| Merced, CACalifornia | $152.25 | $73.55 |
| Modesto, CACalifornia | $152.25 | $73.55 |
| Napa, CACalifornia | $174.53 | $79.88 |
| Oxnard, CACalifornia | $161.18 | $76.30 |
| Redding, CACalifornia | $152.25 | $73.55 |
| Rest of CaliforniaCalifornia | $152.25 | $73.55 |
| Riverside, CACalifornia | $154.31 | $75.61 |
| Sacramento, CACalifornia | $159.28 | $75.76 |
| Salinas, CACalifornia | $158.67 | $75.44 |
| San Diego, CACalifornia | $162.04 | $76.15 |
| Marin County, CACalifornia | $184.15 | $82.89 |
| San Francisco, CACalifornia | $183.93 | $82.68 |
| San Benito County, CACalifornia | $188.28 | $84.72 |
| Santa Clara County, CACalifornia | $187.40 | $83.84 |
| San Luis Obispo, CACalifornia | $156.18 | $74.38 |
| Santa Cruz, CACalifornia | $163.30 | $76.05 |
| Santa Maria, CACalifornia | $159.17 | $75.43 |
| Santa Rosa, CACalifornia | $164.92 | $76.73 |
| Stockton, CACalifornia | $152.25 | $73.55 |
| Vallejo, CACalifornia | $174.22 | $79.57 |
| Visalia, CACalifornia | $152.25 | $73.55 |
| Yuba City, CACalifornia | $152.25 | $73.55 |
| ColoradoColorado | $150.65 | $74.24 |
| ConnecticutConnecticut | $154.94 | $77.60 |
| DelawareDelaware | $144.13 | $73.18 |
| Fort Lauderdale, FLFlorida | $151.94 | $79.20 |
| Rest of FloridaFlorida | $144.81 | $76.16 |
| Atlanta, GAGeorgia | $148.51 | $75.55 |
| Rest of GeorgiaGeorgia | $137.00 | $72.94 |
| Hawaii, Guam, HIHawaii | $155.45 | $73.80 |
| IowaIowa | $134.05 | $68.34 |
| IdahoIdaho | $134.99 | $68.92 |
| East St. Louis, ILIllinois | $144.77 | $78.70 |
| Rest of IllinoisIllinois | $141.27 | $75.70 |
| Suburban Chicago, ILIllinois | $153.33 | $79.57 |
| IndianaIndiana | $135.71 | $69.14 |
| KansasKansas | $133.73 | $68.81 |
| KentuckyKentucky | $134.97 | $71.13 |
| New Orleans, LALouisiana | $141.11 | $73.54 |
| Rest of LouisianaLouisiana | $134.88 | $71.32 |
| Metropolitan Boston, MAMassachusetts | $164.59 | $78.85 |
| Rest of MassachusettsMassachusetts | $149.94 | $74.32 |
| Baltimore area, MDMaryland | $154.56 | $77.50 |
| Rest of MarylandMaryland | $146.68 | $74.01 |
| Rest of MaineMaine | $135.93 | $69.87 |
| Southern Maine, MEMaine | $142.47 | $71.30 |
| Detroit, MIMichigan | $146.79 | $77.49 |
| Rest of MichiganMichigan | $138.51 | $72.95 |
| MinnesotaMinnesota | $143.80 | $69.91 |
| Metropolitan Kansas City, MOMissouri | $139.92 | $72.49 |
| Metropolitan St. Louis, MOMissouri | $141.26 | $72.90 |
| Rest of MissouriMissouri | $132.88 | $70.98 |
| MississippiMississippi | $131.30 | $69.47 |
| MontanaMontana | $145.62 | $73.80 |
| North CarolinaNorth Carolina | $137.23 | $70.23 |
| North DakotaNorth Dakota | $141.86 | $70.05 |
| NebraskaNebraska | $134.66 | $68.38 |
| New HampshireNew Hampshire | $148.57 | $73.82 |
| Northern New JerseyNew Jersey | $163.68 | $80.38 |
| Rest of New JerseyNew Jersey | $156.56 | $78.14 |
| New MexicoNew Mexico | $139.34 | $73.48 |
| NevadaNevada | $144.66 | $72.78 |
| NYC suburbs and Long Island, NYNew York | $171.38 | $85.99 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $157.79 | $79.15 |
| Queens, NYNew York | $168.11 | $83.23 |
| Rest of New YorkNew York | $139.18 | $70.96 |
| OhioOhio | $137.75 | $72.18 |
| OklahomaOklahoma | $134.46 | $70.33 |
| Portland, OROregon | $154.89 | $75.11 |
| Rest of OregonOregon | $143.38 | $71.85 |
| Metropolitan Philadelphia, PAPennsylvania | $151.46 | $76.70 |
| Rest of PennsylvaniaPennsylvania | $137.80 | $71.88 |
| Puerto RicoPuerto Rico | $146.54 | $73.93 |
| Rhode IslandRhode Island | $148.87 | $74.68 |
| South CarolinaSouth Carolina | $137.75 | $71.39 |
| South DakotaSouth Dakota | $141.41 | $69.60 |
| TennesseeTennessee | $134.39 | $69.11 |
| Austin, TXTexas | $150.29 | $74.31 |
| Beaumont, TXTexas | $136.97 | $71.62 |
| Brazoria, TXTexas | $143.80 | $72.63 |
| Dallas, TXTexas | $144.79 | $73.27 |
| Fort Worth, TXTexas | $143.97 | $73.16 |
| Galveston, TXTexas | $144.28 | $72.97 |
| Houston, TXTexas | $147.76 | $76.45 |
| Rest of TexasTexas | $140.36 | $72.21 |
| UtahUtah | $139.51 | $72.01 |
| VirginiaVirginia | $142.21 | $71.62 |
| Virgin Islands, VIUnited States Virgin Islands | $146.54 | $73.93 |
| VermontVermont | $141.58 | $70.49 |
| Rest of WashingtonWashington | $149.57 | $73.95 |
| King County, WAWashington | $167.57 | $79.46 |
| WisconsinWisconsin | $137.41 | $68.61 |
| West VirginiaWest Virginia | $136.42 | $74.01 |
| WyomingWyoming | $143.98 | $72.17 |
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.
The exact Washington, DC area inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
6,233
- Code
- 53866
- Physician work
- 1.44
- Practice expense
- 2.73
- Malpractice
- 0.19
GPCI2026.csv
39
- Locality
- Washington, DC area
- Physician work
- 1.054
- Practice expense
- 1.178
- Malpractice
- 1.113
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.44 | × 1.054 | 1.5178 |
| Practice expense | 2.73 | × 1.178 | 3.2159 |
| Malpractice | 0.19 | × 1.113 | 0.2115 |
| Total RVUs | 4.9452 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Washington, DC area$165.17
Office: (1.44 × 1.054 + 2.73 × 1.178 + 0.19 × 1.113) × $33.4009 = $165.17
Facility: (1.44 × 1.054 + 0.58 × 1.178 + 0.19 × 1.113) × $33.4009 = $80.58
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%).
How 53866 has changed in Washington, DC area
53866 · Office / nonfacility
$165.17
Effective 2026-10-01
The base rate is $8.68 higher than on 2025-10-01, moving from $156.49 to $165.17 (5.5%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$156.49changed to$165.17
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.48 changed to 1.44
- Practice expense RVU 2.57 changed to 2.73
- Malpractice RVU 0.18 changed to 0.19
- Work GPCI 1.057 changed to 1.054
- Practice expense GPCI 1.192 changed to 1.178
- Malpractice GPCI 1.168 changed to 1.113
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
No ratechanged to$156.49
Held through RVU25B, RVU25C, RVU25D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D, RVU20A, RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D, RVU22A, RVU22B, RVU22C, RVU22D, RVU23A, RVU23B, RVU23C, RVU23D, RVU24A, RVU24AR, RVU24B, RVU24C, RVU24D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $165.17 | $80.58 | RVU26D |
| 2026-07-01 | $165.17 | $80.58 | RVU26C |
| 2026-04-01 | $165.17 | $80.58 | RVU26B |
| 2026-01-01 | $165.17 | $80.58 | RVU26A |
| 2025-10-01 | $156.49 | $88.25 | RVU25D |
| 2025-07-01 | $156.49 | $88.25 | RVU25C |
| 2025-04-01 | $156.49 | $88.25 | RVU25B |
| 2025-01-01 | $156.49 | $88.25 | RVU25A |
| 2024-10-01 | Not in this release | Not in this release | RVU24D |
| 2024-07-01 | Not in this release | Not in this release | RVU24C |
| 2024-04-01 | Not in this release | Not in this release | RVU24B |
| 2024-03-09 | Not in this release | Not in this release | RVU24AR |
| 2024-01-01 | Not in this release | Not in this release | RVU24A |
| 2023-10-01 | Not in this release | Not in this release | RVU23D |
| 2023-07-01 | Not in this release | Not in this release | RVU23C |
| 2023-04-01 | Not in this release | Not in this release | RVU23B |
| 2023-01-01 | Not in this release | Not in this release | RVU23A |
| 2022-10-01 | Not in this release | Not in this release | RVU22D |
| 2022-07-01 | Not in this release | Not in this release | RVU22C |
| 2022-04-01 | Not in this release | Not in this release | RVU22B |
| 2022-01-01 | Not in this release | Not in this release | RVU22A |
| 2021-10-01 | Not in this release | Not in this release | RVU21D |
| 2021-07-01 | Not in this release | Not in this release | RVU21C |
| 2021-04-01 | Not in this release | Not in this release | RVU21B |
| 2021-01-01 | Not in this release | Not in this release | RVU21A |
| 2020-10-01 | Not in this release | Not in this release | RVU20D |
| 2020-07-01 | Not in this release | Not in this release | RVU20C |
| 2020-04-01 | Not in this release | Not in this release | RVU20B |
| 2020-01-01 | Not in this release | Not in this release | RVU20A |
| 2019-10-01 | Not in this release | Not in this release | RVU19D |
| 2019-07-01 | Not in this release | Not in this release | RVU19C |
| 2019-04-01 | Not in this release | Not in this release | RVU19B |
| 2019-01-01 | Not in this release | Not in this release | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Washington, DC area rate applies
Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.
- Washington
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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