CPT code 55867: Prostatectomy, laparoscopic simple2026 Medicare rate & RVUs in Montana

Reports laparoscopic removal of obstructing prostate tissue while preserving the capsule, typically for benign enlargement causing significant urinary obstruction.

CMS RVU26DEffective Oct 1, 2026One payment locality5.3K Medicare services in 2024

In Montana, Medicare pays $945.75 for 55867 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$945.75Hospital or facility

Check a contract rate as a % of Medicare · 55867 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 55867 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Montana
  2. What 55867 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 55867 covers

A urologist uses a laparoscopic approach to remove obstructing adenomatous prostate tissue while leaving the prostate capsule and surrounding structures. This simple, subtotal operation is used for conditions such as benign prostatic enlargement with substantial urinary obstruction; it is distinct from removal of the prostate and surrounding tissue as a radical cancer operation. The service is generally performed in an operating room at a hospital or ambulatory surgery facility.

Report the code when the operative documentation supports laparoscopic access and a simple subtotal prostatectomy. The note should identify the approach and the extent and purpose of prostate tissue removal, distinguishing it from a radical procedure or a different surgical route. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery payment may be allowed; co-surgeon payment requires supporting documentation. Team surgery is not permitted, and 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.

How Montana compares for 55867

Across 109 of 109 payment localities, the facility rate for 55867 runs from $873.94 in Arkansas to $1,241.80 in Alaska. Montana pays $945.75. The RVUs are the same everywhere; the geographic indexes change the dollars.

55867 in Montana vs other payment areas
  1. Montana · this page$945.75
  2. Los Angeles, CA · California$986.07+$40.32
  3. Washington, DC area · District of Columbia$1,030.09+$84.34
  4. Miami, FL · Florida$1,080.89+$135.14
  5. Chicago, IL · Illinois$1,057.91+$112.16
  6. Manhattan, NY · New York$1,071.67+$125.92
  7. Alaska · Alaska$1,241.80+$296.05

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

Every other payment area

55867 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$881.78
ArkansasArkansas—$873.94
ArizonaArizona—$927.02
Bakersfield, CACalifornia—$947.74
Chico, CACalifornia—$940.47
El Centro, CACalifornia—$940.88
Fresno, CACalifornia—$940.47
Hanford, CACalifornia—$940.47

55867 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.

View every state and territory as a table
55867 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 55867 in every payment locality

How the 55867 rate is calculated

Each of 55867’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 · 55867

RVUs × geographic indexes × conversion factor

Office or facility?

Work19.04

19.04 RVUs× 1.000 GPCI

Practice expense6.82

6.82 RVUs× 1.000 GPCI

Malpractice2.46

2.46 RVUs× 1.000 GPCI

Adjusted RVUs

28.3200

Conversion factor

$33.4009

Medicare rate

$945.91

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

The exact Montana inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,387

Code
55867
Physician work
19.04
Practice expense
6.82
Malpractice
2.46

GPCI2026.csv

71

Locality
Montana
Physician work
1.000
Practice expense
1.000
Malpractice
0.998
Facility calculation for 55867 in Montana
ComponentRVULocality factorAdjusted
Physician work19.04× 1.00019.0400
Practice expense6.82× 1.0006.8200
Malpractice2.46× 0.9982.4551
Total RVUs28.3151
Conversion factor× 33.4009

Facility rate, Montana$945.75

Facility: (19.04 × 1 + 6.82 × 1 + 2.46 × 0.998) × $33.4009 = $945.75

Open 55867 in the RVU calculator

Payment rules and modifiers for 55867

55867 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 55867

Prostatectomy, laparoscopic simple

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 · 55867

Prostatectomy, laparoscopic simple

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

55867 without 51 · national facility

$945.91

Prostatectomy, laparoscopic simple

55867-51 · Second procedure: 50%

$472.96

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 55867 has changed in Montana

55867 · 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
  1. January 1, 2023

    RVU23A

    No ratechanged toNo rate

    Held through RVU23B, RVU23C, RVU23D, RVU24A, RVU24AR, RVU24B, RVU24C, RVU24D, RVU25A, RVU25B, RVU25C, RVU25D, RVU26A, RVU26B, RVU26C, RVU26D.

  2. 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.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$945.75RVU26D
2026-07-01Not available in this setting$945.75RVU26C
2026-04-01Not available in this setting$945.75RVU26B
2026-01-01Not available in this setting$945.75RVU26A
2025-10-01Not available in this setting$1,014.64RVU25D
2025-07-01Not available in this setting$1,014.64RVU25C
2025-04-01Not available in this setting$1,014.64RVU25B
2025-01-01Not available in this setting$1,014.64RVU25A
2024-10-01Not available in this setting$1,037.16RVU24D
2024-07-01Not available in this setting$1,037.16RVU24C
2024-04-01Not available in this setting$1,037.16RVU24B
2024-03-09Not available in this setting$1,037.16RVU24AR
2024-01-01Not available in this setting$1,020.23RVU24A
2023-10-01Not available in this setting$1,045.04RVU23D
2023-07-01Not available in this setting$1,045.04RVU23C
2023-04-01Not available in this setting$1,045.04RVU23B
2023-01-01Not available in this setting$1,045.04RVU23A
2022-10-01Not in this releaseNot in this releaseRVU22D
2022-07-01Not in this releaseNot in this releaseRVU22C
2022-04-01Not in this releaseNot in this releaseRVU22B
2022-01-01Not in this releaseNot in this releaseRVU22A
2021-10-01Not in this releaseNot in this releaseRVU21D
2021-07-01Not in this releaseNot in this releaseRVU21C
2021-04-01Not in this releaseNot in this releaseRVU21B
2021-01-01Not in this releaseNot in this releaseRVU21A
2020-10-01Not in this releaseNot in this releaseRVU20D
2020-07-01Not in this releaseNot in this releaseRVU20C
2020-04-01Not in this releaseNot in this releaseRVU20B
2020-01-01Not in this releaseNot in this releaseRVU20A
2019-10-01Not in this releaseNot in this releaseRVU19D
2019-07-01Not in this releaseNot in this releaseRVU19C
2019-04-01Not in this releaseNot in this releaseRVU19B
2019-01-01Not in this releaseNot in this releaseRVU19A
2018-10-01Not in this releaseNot in this releaseRVU18D
2018-07-01Not in this releaseNot in this releaseRVU18C
2018-04-01Not in this releaseNot in this releaseRVU18B
2018-01-01Not in this releaseNot in this releaseRVU18AR1
2017-10-01Not in this releaseNot in this releaseRVU17D
2017-07-01Not in this releaseNot in this releaseRVU17C
2017-04-01Not in this releaseNot in this releaseRVU17B
2017-01-01Not in this releaseNot in this releaseRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 55867 for an earlier date of service

Where the Montana rate applies

Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.

  • Absarokee
  • Acton
  • Alberton
  • Alder
  • Alzada
  • Amsterdam
  • Anaconda-Deer Lodge County
  • Antelope

Browse all communities in Montana

55867 billing questions

How does this differ from laparoscopic radical prostatectomy?

This code is for simple subtotal removal of obstructing prostate tissue with the capsule preserved. Use the radical procedure code when the operation removes the prostate as a cancer operation.

Can this code be used for an open simple prostatectomy?

No. This code identifies the laparoscopic approach; open retropubic and perineal simple prostatectomies have separate codes.

Is modifier 50 appropriate for this procedure?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How are other procedures performed in the same session paid?

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

Are assistant or co-surgeon services payable?

Assistant-at-surgery payment may be allowed. Co-surgeons are paid only when supporting documentation is provided.

What postoperative care is included in the global period?

The 90-day global period includes the day-before preoperative visit and 90 days of related 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
RVUs for 55867PPRRVU2026_Oct_nonQPP.csv, line 6,387 (RVU26D)
Geographic factors for MontanaGPCI2026.csv, line 71 (RVU26D)

Open CMS sourceHow we calculate rates

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