CPT code 55842: Radical prostatectomy, limited bilateral lymphadenectomy2026 Medicare rate & RVUs

Medicare pays $1,042.78 for 55842 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 55842 covers

An urologist reports 55842 for an open retropubic radical prostatectomy that removes the prostate together with limited bilateral pelvic lymph-node dissection. It is used most often for prostate cancer when the operative plan includes nodal staging. The hospital operating room is the typical setting; this code distinguishes the retropubic approach and limited node dissection from perineal, laparoscopic, or more extensive operations.

Choose the code from the operative report’s approach and extent: open retropubic radical removal plus limited bilateral pelvic node work. Documentation should support the radical prostatectomy and the extent and laterality of the lymphadenectomy. This major surgery has a 90-day global period that includes the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate.

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 55842 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

55842 rates by state

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

How the 55842 rate is calculated

Each of 55842’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 55842

55842 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

55842 compared with similar codes

How to choose

55840Radical prostatectomyRetropubic approach

Choose 55842 when the open retropubic radical prostatectomy includes limited bilateral pelvic lymphadenectomy. Choose 55840 when that nodal dissection is not performed.

55845Radical prostatectomyRetropubic, extensive node dissection

Both are open retropubic radical procedures with bilateral pelvic lymphadenectomy. 55845 reflects the more extensive dissection involving external iliac, hypogastric, and obturator nodes.

55812Radical prostatectomyPerineal with bilateral lymphadenectomy

55812 uses the perineal approach for radical prostatectomy with bilateral pelvic lymphadenectomy; 55842 is the retropubic approach with limited nodal dissection.

55866ProstatectomyLaparoscopic, radical

55866 represents laparoscopic radical retropubic prostatectomy, including robotic-assisted surgery. Use 55842 for the open retropubic operation with limited bilateral pelvic lymphadenectomy.

Codes related to 55842

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