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CPT code 55866: Prostatectomy, laparoscopic, radical2026 Medicare rate & RVUs

Report this service for laparoscopic radical removal of the prostate, including nerve-sparing work and robotic assistance when used, typically for prostate cancer.

CMS RVU26DEffective Oct 1, 2026109 payment localities25.1K Medicare services in 2024

Medicare pays $1,081.86 for 55866 nationally in a facility.

Medicare rate · 55866

Prostatectomy, laparoscopic, radical

Office or facility?

Work RVUs
21.9
Total RVUs
32.39
Global days
090

National rate · 2026

$1,081.86

Facility setting, before claim adjustments.

See every locality for 55866 →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.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 55866 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 55866 covers

A urologist removes the prostate through a laparoscopic approach, using small abdominal incisions and instruments to dissect and remove the gland. The operation may include preservation of the neurovascular bundles when clinically appropriate; robotic assistance is included when used. This approach is commonly selected for patients undergoing radical prostate surgery for prostate cancer, with most Medicare services performed in a facility.

Select this code for a radical laparoscopic prostatectomy, not a simple or subtotal prostate removal. The operative report should establish the laparoscopic approach, radical intent, structures removed, and any nerve-sparing work or robotic assistance. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; 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 55866 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

55866 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,008.85
AlaskaUnavailable$1,421.78
ArizonaUnavailable$1,060.31
ArkansasUnavailable$999.94
Atlanta, GAUnavailable$1,107.14
Austin, TXUnavailable$1,087.38
Bakersfield, CAUnavailable$1,083.36
Baltimore area, MDUnavailable$1,134.64
Beaumont, TXUnavailable$1,052.12
Brazoria, TXUnavailable$1,064.61

55866 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
55866 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

How the 55866 rate is calculated

Each of 55866’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 · 55866

RVUs × geographic indexes × conversion factor

Office or facility?

Work21.90

21.90 RVUs× 1.000 GPCI

Practice expense7.66

7.66 RVUs× 1.000 GPCI

Malpractice2.83

2.83 RVUs× 1.000 GPCI

Adjusted RVUs

32.3900

Conversion factor

$33.4009

Medicare rate

$1,081.86

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

Payment rules and modifiers for 55866

55866 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 55866

Prostatectomy, laparoscopic, radical

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)0.08/0.83/0.09Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 55866

Prostatectomy, laparoscopic, radical

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

55866 without 51 · national facility

$1,081.86

Prostatectomy, laparoscopic, radical

55866-51 · Second procedure: 50%

$540.93

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

55866 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 55866

    Prostatectomy, laparoscopic, radical21.9 wRVU

    Not priced

  • 55840

    Radical prostatectomy, retropubic approach20.83 wRVU

    Not priced

  • 55845

    Radical prostatectomy, retropubic, extensive node dissection24.55 wRVU

    Not priced

  • 55867

    Prostatectomy, laparoscopic simple19.04 wRVU

    Not priced

How to choose

55840Radical prostatectomyRetropubic approach
Use 55840 for an open retropubic radical prostatectomy. Use 55866 when the radical procedure is performed laparoscopically.
55845Radical prostatectomyRetropubic, extensive node dissection
55845 describes an open radical prostatectomy with bilateral pelvic lymphadenectomy. This code identifies the laparoscopic radical prostatectomy approach.
55867ProstatectomyLaparoscopic simple
55867 is for simple or subtotal prostate removal performed laparoscopically. This code is for radical prostate removal.

Codes related to 55866

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

Codes related to 55866
CodeHow it relatesNational office range
Used instead
55840Radical prostatectomy, retropubic approachOpen retropubic radical prostatectomy for a similar surgical need using a different approach.No office rate
55845Radical prostatectomy, retropubic, extensive node dissectionOpen radical prostatectomy with bilateral pelvic lymphadenectomy, rather than a laparoscopic approach.No office rate
55810Radical prostatectomy, perineal approachRadical prostatectomy through a perineal approach rather than laparoscopically.No office rate
Same family
55867Prostatectomy, laparoscopic simpleLaparoscopic simple or subtotal prostate removal, differing from this code in extent.No office rate

55866 billing questions

Does robotic assistance require a different code?

No. Robotic assistance, when used for this laparoscopic radical prostatectomy, is included in the service.

How does this differ from 55867?

55866 describes radical prostate removal; 55867 is for simple or subtotal prostate removal. Choose based on the operation performed, not whether a robot is used.

Should modifier 50 be reported?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this procedure.

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 allowed. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How are other same-session procedures paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.

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 55866PPRRVU2026_Oct_nonQPP.csv, line 6,386 (RVU26D)

Open CMS sourceHow we calculate rates

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