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

Reports radical removal of the prostate through a perineal approach when bilateral pelvic lymphadenectomy is performed during the same operative service.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Connecticut, Medicare pays $1,501.89 for 55812 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$1,501.89Hospital or facility

Check a contract rate as a % of Medicare · 55812 nationwide

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

We’ll open 55812 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 55812 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Connecticut compares for 55812

Across 109 of 109 payment localities, the facility rate for 55812 runs from $1,323.00 in Arkansas to $1,882.55 in Alaska. Connecticut pays $1,501.89. The RVUs are the same everywhere; the geographic indexes change the dollars.

55812 in Connecticut vs other payment areas
  1. Connecticut · this page$1,501.89
  2. Los Angeles, CA · California$1,489.14−$12.75
  3. Washington, DC area · District of Columbia$1,556.37+$54.48
  4. Miami, FL · Florida$1,635.69+$133.80
  5. Chicago, IL · Illinois$1,601.24+$99.35
  6. Manhattan, NY · New York$1,620.04+$118.15
  7. Alaska · Alaska$1,882.55+$380.66

Other areas in Connecticut first, then benchmark localities. Bars start at $0.

Every other payment area

55812 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$1,334.70
ArkansasArkansas—$1,323.00
ArizonaArizona—$1,402.23
Bakersfield, CACalifornia—$1,431.95
Chico, CACalifornia—$1,420.86
El Centro, CACalifornia—$1,421.49
Fresno, CACalifornia—$1,420.86
Hanford, CACalifornia—$1,420.86

55812 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
55812 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 55812 in every payment locality

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.

How the rate is built · 55812

RVUs × geographic indexes × conversion factor

Office or facility?

Work29.14

29.14 RVUs× 1.000 GPCI

Practice expense9.94

9.94 RVUs× 1.000 GPCI

Malpractice3.75

3.75 RVUs× 1.000 GPCI

Adjusted RVUs

42.8300

Conversion factor

$33.4009

Medicare rate

$1,430.56

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Connecticut inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,376

Code
55812
Physician work
29.14
Practice expense
9.94
Malpractice
3.75

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Facility calculation for 55812 in Connecticut
ComponentRVULocality factorAdjusted
Physician work29.14× 1.02029.7228
Practice expense9.94× 1.07710.7054
Malpractice3.75× 1.2104.5375
Total RVUs44.9657
Conversion factor× 33.4009

Facility rate, Connecticut$1501.89

Facility: (29.14 × 1.02 + 9.94 × 1.077 + 3.75 × 1.21) × $33.4009 = $1501.89

Open 55812 in the RVU calculator

Payment rules and modifiers for 55812

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

CMS payment indicators · 55812

Radical prostatectomy, perineal with bilateral lymphadenectomy

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 55812

Radical prostatectomy, perineal with bilateral lymphadenectomy

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

55812 without 51 · national facility

$1,430.56

Radical prostatectomy, perineal with bilateral lymphadenectomy

55812-51 · Second procedure: 50%

$715.28

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%).

When to use modifier 51

How 55812 has changed in Connecticut

55812 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$1,501.89RVU26D
2026-07-01Not available in this setting$1,501.89RVU26C
2026-04-01Not available in this setting$1,501.89RVU26B
2026-01-01Not available in this setting$1,501.89RVU26A
2025-10-01Not available in this setting$1,641.11RVU25D
2025-07-01Not available in this setting$1,641.11RVU25C
2025-04-01Not available in this setting$1,641.11RVU25B
2025-01-01Not available in this setting$1,641.11RVU25A
2024-10-01Not available in this setting$1,678.43RVU24D
2024-07-01Not available in this setting$1,678.43RVU24C
2024-04-01Not available in this setting$1,678.43RVU24B
2024-03-09Not available in this setting$1,678.43RVU24AR
2024-01-01Not available in this setting$1,651.04RVU24A
2023-10-01Not available in this setting$1,686.94RVU23D
2023-07-01Not available in this setting$1,686.94RVU23C
2023-04-01Not available in this setting$1,686.94RVU23B
2023-01-01Not available in this setting$1,686.94RVU23A
2022-10-01Not available in this setting$1,706.23RVU22D
2022-07-01Not available in this setting$1,706.23RVU22C
2022-04-01Not available in this setting$1,706.23RVU22B
2022-01-01Not available in this setting$1,706.23RVU22A
2021-10-01Not available in this setting$1,716.53RVU21D
2021-07-01Not available in this setting$1,716.53RVU21C
2021-04-01Not available in this setting$1,716.53RVU21B
2021-01-01Not available in this setting$1,716.53RVU21A
2020-10-01Not available in this setting$1,774.03RVU20D
2020-07-01Not available in this setting$1,774.03RVU20C
2020-04-01Not available in this setting$1,774.03RVU20B
2020-01-01Not available in this setting$1,774.03RVU20A
2019-10-01Not available in this setting$1,785.80RVU19D
2019-07-01Not available in this setting$1,785.80RVU19C
2019-04-01Not available in this setting$1,785.80RVU19B
2019-01-01Not available in this setting$1,785.80RVU19A
2018-10-01Not available in this setting$1,786.89RVU18D
2018-07-01Not available in this setting$1,786.89RVU18C
2018-04-01Not available in this setting$1,786.89RVU18B
2018-01-01Not available in this setting$1,786.89RVU18AR1
2017-10-01Not available in this setting$1,835.55RVU17D
2017-07-01Not available in this setting$1,835.55RVU17C
2017-04-01Not available in this setting$1,835.55RVU17B
2017-01-01Not available in this setting$1,835.55RVU17A
2016-10-01Not available in this setting$1,766.95RVU16D
2016-07-01Not available in this setting$1,766.95RVU16C
2016-04-01Not available in this setting$1,766.95RVU16B
2016-01-01Not available in this setting$1,766.95RVU16A
2015-10-01Not available in this setting$1,770.06RVU15D
2015-07-01Not available in this setting$1,770.06RVU15C
2015-04-01Not available in this setting$1,761.25RVU15B
2015-01-01Not available in this setting$1,761.25RVU15A
2014-10-01Not available in this setting$1,738.65RVU14D
2014-07-01Not available in this setting$1,738.65RVU14C
2014-04-01Not available in this setting$1,738.65RVU14B
2014-01-01Not available in this setting$1,738.65RVU14A
2013-10-01Not available in this setting$1,677.99RVU13D
2013-07-01Not available in this setting$1,677.99RVU13C
2013-04-01Not available in this setting$1,677.99RVU13B
2013-01-01Not available in this setting$1,677.99RVU13AR

Price 55812 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

55812 billing questions

How does this differ from 55810?

55812 includes bilateral pelvic lymphadenectomy with the perineal radical prostatectomy. Use 55810 for the perineal radical prostatectomy without that lymphadenectomy.

Can the pelvic lymphadenectomy be billed separately?

The bilateral pelvic lymphadenectomy is included in 55812 when performed as part of this combined operation. The operative report should document the nodal work performed.

Should modifier 50 be appended?

No. Modifier 50 is inappropriate for this prostate operation; bilateral lymphadenectomy is part of the code’s described service.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.

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
RVUs for 55812PPRRVU2026_Oct_nonQPP.csv, line 6,376 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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