CPT code 55812: Radical prostatectomy, perineal with bilateral lymphadenectomy2026 Medicare rate & RVUs

Medicare pays $1,430.56 for 55812 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 55812 covers

This code describes radical prostate removal through an incision in the perineum, together with removal of lymph nodes from both sides of the pelvis. Urologists typically perform the operation in a hospital operating room for prostate cancer. The operative report should establish the perineal approach and document the bilateral lymphadenectomy performed as part of the surgical service.

Choose this code when both the perineal radical prostatectomy and bilateral pelvic lymphadenectomy are performed; a perineal radical prostatectomy without lymphadenectomy is a different code. The lymphadenectomy is included in this combined service, rather than separately reported as a second service for the same work. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this operation. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is 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 55812 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

55812 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 55812 rate is calculated

Each of 55812’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.

Payment rules and modifiers for 55812

55812 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

55812 compared with similar codes

How to choose

55810Radical prostatectomyPerineal approach

Both describe perineal radical prostatectomy, but 55812 includes bilateral pelvic lymphadenectomy. Choose 55810 when that lymphadenectomy is not performed.

55815Radical prostatectomyPerineal with bilateral node dissection

This is a neighboring perineal prostatectomy code for a more specifically described extent of pelvic node dissection. Compare the operative report’s documented nodal extent when selecting between the codes.

55842Radical prostatectomyLimited bilateral lymphadenectomy

55842 describes a retropubic radical prostatectomy with bilateral pelvic lymphadenectomy. 55812 is for the perineal approach.

55866ProstatectomyLaparoscopic, radical

55866 describes laparoscopic radical prostatectomy; 55812 describes the perineal operation with bilateral pelvic lymphadenectomy.

Codes related to 55812

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates