CPT code 55873: Prostate cryoablation, ultrasound-guided freeze treatment2026 Medicare rate & RVUs in Idaho
Reports prostate tissue destruction by cryotherapy, typically for localized prostate cancer or recurrent disease, with ultrasound guidance and monitoring included.
In Idaho, Medicare pays $5,246.39 for 55873 in the office and $643.52 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 55873 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 55873 covers
A urologist uses probes placed through the perineum to freeze prostate tissue, with ultrasound used to guide and monitor treatment. The procedure is commonly performed in a hospital or ambulatory surgery setting for localized prostate cancer, including selected cases treated after recurrence following radiation. The treatment may target the gland or a defined area, depending on the clinical plan.
Report the service when the documented procedure uses cryotherapy to ablate prostate tissue; the operative note should identify the indication, treatment extent, probe placement, and freezing process. Ultrasound guidance and monitoring are included in the service. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing are 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 Idaho compares for 55873
Across 109 of 109 payment localities, the office rate for 55873 runs from $4,932.04 in Arkansas to $8,008.98 in San Benito County, CA. Idaho pays $5,246.39. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Idaho · this page$5,246.39
- Los Angeles, CA · California$6,640.87+$1,394.48
- Washington, DC area · District of Columbia$6,646.01+$1,399.62
- Miami, FL · Florida$5,990.70+$744.31
- Chicago, IL · Illinois$5,793.67+$547.28
- Manhattan, NY · New York$6,594.07+$1,347.68
- Alaska · Alaska$6,225.11+$978.72
Other areas in Idaho first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $5,017.99 | $640.26 |
| ArkansasArkansas | $4,932.04 | $634.36 |
| ArizonaArizona | $5,522.43 | $674.40 |
| Bakersfield, CACalifornia | $6,176.31 | $692.89 |
| Chico, CACalifornia | $6,171.30 | $687.88 |
| El Centro, CACalifornia | $6,171.58 | $688.16 |
| Fresno, CACalifornia | $6,171.30 | $687.88 |
| Hanford, CACalifornia | $6,171.30 | $687.88 |
| Madera, CACalifornia | $6,171.30 | $687.88 |
| Merced, CACalifornia | $6,171.30 | $687.88 |
| Modesto, CACalifornia | $6,171.30 | $687.88 |
| Napa, CACalifornia | $7,342.75 | $748.64 |
| Oxnard, CACalifornia | $6,627.61 | $713.92 |
| Redding, CACalifornia | $6,171.30 | $687.88 |
| Rest of CaliforniaCalifornia | $6,171.30 | $687.88 |
| Riverside, CACalifornia | $6,189.64 | $706.22 |
| Sacramento, CACalifornia | $6,527.59 | $708.96 |
| Salinas, CACalifornia | $6,504.61 | $705.99 |
| San Diego, CACalifornia | $6,696.61 | $712.88 |
| Marin County, CACalifornia | $7,831.84 | $777.44 |
| San Francisco, CACalifornia | $7,829.92 | $775.52 |
| San Benito County, CACalifornia | $8,008.98 | $794.48 |
| Santa Clara County, CACalifornia | $8,001.13 | $786.63 |
| San Luis Obispo, CACalifornia | $6,394.56 | $696.01 |
| Santa Cruz, CACalifornia | $6,790.94 | $712.15 |
| Santa Maria, CACalifornia | $6,539.62 | $705.98 |
| Santa Rosa, CACalifornia | $6,862.42 | $718.59 |
| Stockton, CACalifornia | $6,171.30 | $687.88 |
| Vallejo, CACalifornia | $7,339.99 | $745.87 |
| Visalia, CACalifornia | $6,171.30 | $687.88 |
| Yuba City, CACalifornia | $6,171.30 | $687.88 |
| ColoradoColorado | $6,016.76 | $693.44 |
| ConnecticutConnecticut | $6,112.02 | $723.66 |
| DelawareDelaware | $5,625.72 | $682.64 |
| Fort Lauderdale, FLFlorida | $5,804.62 | $736.46 |
| Rest of FloridaFlorida | $5,491.45 | $708.47 |
| Atlanta, GAGeorgia | $5,787.26 | $704.09 |
| Rest of GeorgiaGeorgia | $5,141.60 | $678.81 |
| Hawaii, Guam, HIHawaii | $6,379.08 | $690.53 |
| IowaIowa | $5,216.14 | $638.29 |
| East St. Louis, ILIllinois | $5,333.38 | $730.51 |
| Rest of IllinoisIllinois | $5,271.57 | $703.73 |
| Suburban Chicago, ILIllinois | $5,878.38 | $740.17 |
| IndianaIndiana | $5,283.47 | $645.58 |
| KansasKansas | $5,165.07 | $642.25 |
| KentuckyKentucky | $5,110.38 | $662.61 |
| New Orleans, LALouisiana | $5,392.85 | $684.92 |
| Rest of LouisianaLouisiana | $5,092.04 | $664.28 |
| Metropolitan Boston, MAMassachusetts | $6,710.74 | $737.02 |
| Rest of MassachusettsMassachusetts | $5,962.33 | $694.04 |
| Baltimore area, MDMaryland | $6,091.01 | $722.66 |
| Rest of MarylandMaryland | $5,753.62 | $690.46 |
| Rest of MaineMaine | $5,254.80 | $651.93 |
| Southern Maine, MEMaine | $5,623.95 | $665.86 |
| Detroit, MIMichigan | $5,548.51 | $720.50 |
| Rest of MichiganMichigan | $5,247.08 | $679.23 |
| MinnesotaMinnesota | $5,802.35 | $654.14 |
| Metropolitan Kansas City, MOMissouri | $5,373.49 | $675.56 |
| Metropolitan St. Louis, MOMissouri | $5,442.40 | $679.43 |
| Rest of MissouriMissouri | $4,973.53 | $660.84 |
| MississippiMississippi | $4,955.07 | $647.38 |
| MontanaMontana | $5,691.40 | $688.28 |
| North CarolinaNorth Carolina | $5,323.26 | $655.35 |
| North DakotaNorth Dakota | $5,657.98 | $654.86 |
| NebraskaNebraska | $5,256.61 | $638.73 |
| New HampshireNew Hampshire | $5,897.34 | $689.09 |
| Northern New JerseyNew Jersey | $6,554.00 | $750.38 |
| Rest of New JerseyNew Jersey | $6,192.38 | $728.98 |
| New MexicoNew Mexico | $5,271.91 | $684.05 |
| NevadaNevada | $5,687.28 | $679.15 |
| NYC suburbs and Long Island, NYNew York | $6,749.55 | $800.84 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $6,216.55 | $738.14 |
| Queens, NYNew York | $6,689.78 | $776.09 |
| Rest of New YorkNew York | $5,415.14 | $662.18 |
| OhioOhio | $5,240.25 | $672.40 |
| OklahomaOklahoma | $5,123.36 | $655.58 |
| Portland, OROregon | $6,260.48 | $702.01 |
| Rest of OregonOregon | $5,653.98 | $670.87 |
| Metropolitan Philadelphia, PAPennsylvania | $5,923.26 | $715.01 |
| Rest of PennsylvaniaPennsylvania | $5,262.65 | $669.79 |
| Puerto RicoPuerto Rico | $5,747.78 | $689.63 |
| Rhode IslandRhode Island | $5,865.17 | $696.95 |
| South CarolinaSouth Carolina | $5,288.44 | $665.56 |
| South DakotaSouth Dakota | $5,654.03 | $650.91 |
| TennesseeTennessee | $5,192.89 | $645.05 |
| Austin, TXTexas | $5,987.11 | $693.81 |
| Beaumont, TXTexas | $5,220.21 | $667.37 |
| Brazoria, TXTexas | $5,635.91 | $677.82 |
| Dallas, TXTexas | $5,666.72 | $683.61 |
| Fort Worth, TXTexas | $5,615.53 | $682.45 |
| Galveston, TXTexas | $5,649.00 | $680.90 |
| Houston, TXTexas | $5,679.94 | $711.84 |
| Rest of TexasTexas | $5,421.24 | $673.28 |
| UtahUtah | $5,374.23 | $671.29 |
| VirginiaVirginia | $5,586.65 | $668.58 |
| Virgin Islands, VIUnited States Virgin Islands | $5,747.78 | $689.63 |
| VermontVermont | $5,611.71 | $658.62 |
| Rest of WashingtonWashington | $5,958.97 | $690.68 |
| King County, WAWashington | $6,881.95 | $743.12 |
| WisconsinWisconsin | $5,434.38 | $641.39 |
| West VirginiaWest Virginia | $5,035.67 | $687.96 |
| WyomingWyoming | $5,676.84 | $673.72 |
55873 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.
$4,932.04
$7,090.14
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $6,225.11 | 1 |
| AL | $5,017.99 | 1 |
| AR | $4,932.04 | 1 |
| AZ | $5,522.43 | 1 |
| CA | $6,171.30–$8,008.98 | 29 |
| CO | $6,016.76 | 1 |
| CT | $6,112.02 | 1 |
| DC | $6,646.01 | 1 |
| DE | $5,625.72 | 1 |
| FL | $5,491.45–$5,990.70 | 3 |
| GA | $5,141.60–$5,787.26 | 2 |
| GU | $6,379.08 | 1 |
| HI | $6,379.08 | 1 |
| IA | $5,216.14 | 1 |
| ID | $5,246.39 | 1 |
| IL | $5,271.57–$5,878.38 | 4 |
| IN | $5,283.47 | 1 |
| KS | $5,165.07 | 1 |
| KY | $5,110.38 | 1 |
| LA | $5,092.04–$5,392.85 | 2 |
| MA | $5,962.33–$6,710.74 | 2 |
| MD | $5,753.62–$6,646.01 | 3 |
| ME | $5,254.80–$5,623.95 | 2 |
| MI | $5,247.08–$5,548.51 | 2 |
| MN | $5,802.35 | 1 |
| MO | $4,973.53–$5,442.40 | 3 |
| MS | $4,955.07 | 1 |
| MT | $5,691.40 | 1 |
| NC | $5,323.26 | 1 |
| ND | $5,657.98 | 1 |
| NE | $5,256.61 | 1 |
| NH | $5,897.34 | 1 |
| NJ | $6,192.38–$6,554.00 | 2 |
| NM | $5,271.91 | 1 |
| NV | $5,687.28 | 1 |
| NY | $5,415.14–$6,749.55 | 5 |
| OH | $5,240.25 | 1 |
| OK | $5,123.36 | 1 |
| OR | $5,653.98–$6,260.48 | 2 |
| PA | $5,262.65–$5,923.26 | 2 |
| PR | $5,747.78 | 1 |
| RI | $5,865.17 | 1 |
| SC | $5,288.44 | 1 |
| SD | $5,654.03 | 1 |
| TN | $5,192.89 | 1 |
| TX | $5,220.21–$5,987.11 | 8 |
| UT | $5,374.23 | 1 |
| VA | $5,586.65–$6,646.01 | 2 |
| VI | $5,747.78 | 1 |
| VT | $5,611.71 | 1 |
| WA | $5,958.97–$6,881.95 | 2 |
| WI | $5,434.38 | 1 |
| WV | $5,035.67 | 1 |
| WY | $5,676.84 | 1 |
How the 55873 rate is calculated
Each of 55873’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 · 55873
RVUs × geographic indexes × conversion factor
Work13.26
13.26 RVUs× 1.000 GPCI
Practice expense155.45
155.45 RVUs× 1.000 GPCI
Malpractice1.69
1.69 RVUs× 1.000 GPCI
Adjusted RVUs
170.4000
Conversion factor
$33.4009
Medicare rate
$5,691.51
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Idaho inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
6,391
- Code
- 55873
- Physician work
- 13.26
- Practice expense
- 155.45
- Malpractice
- 1.69
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.26 | × 1.000 | 13.2600 |
| Practice expense | 155.45 | × 0.920 | 143.0140 |
| Malpractice | 1.69 | × 0.473 | 0.7994 |
| Total RVUs | 157.0734 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Idaho$5246.39
Office: (13.26 × 1 + 155.45 × 0.92 + 1.69 × 0.473) × $33.4009 = $5246.39
Facility: (13.26 × 1 + 5.66 × 0.92 + 1.69 × 0.473) × $33.4009 = $643.52
Payment rules and modifiers for 55873
55873 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 55873
Prostate cryoablation, ultrasound-guided freeze treatment
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.08/0.83/0.09 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 55873
Prostate cryoablation, ultrasound-guided freeze treatment
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
55873 without 51 · national office
$5,691.51
Prostate cryoablation, ultrasound-guided freeze treatment
55873-51 · Second procedure: 50%
$2,845.76
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%).
How 55873 has changed in Idaho
55873 · Office / nonfacility
$5246.39
Effective 2026-10-01
The base rate is $441.34 higher than on 2025-10-01, moving from $4805.05 to $5246.39 (9.2%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$4805.05changed to$5246.39
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 13.60 changed to 13.26
- Practice expense RVU 147.79 changed to 155.45
- Malpractice RVU 1.64 changed to 1.69
- Practice expense GPCI 0.908 changed to 0.920
- Malpractice GPCI 0.461 changed to 0.473
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$5160.80changed to$4805.05
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 154.93 changed to 147.79
- Malpractice RVU 1.65 changed to 1.64
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$5076.57changed to$5160.80
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$5256.72changed to$5076.57
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 157.69 changed to 154.93
- Malpractice RVU 1.61 changed to 1.65
- Practice expense GPCI 0.893 changed to 0.908
- Malpractice GPCI 0.439 changed to 0.461
January 1, 2023
RVU23A
$5433.98changed to$5256.72
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 162.77 changed to 157.69
- Malpractice RVU 1.62 changed to 1.61
- Practice expense GPCI 0.877 changed to 0.893
- Malpractice GPCI 0.416 changed to 0.439
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$5746.06changed to$5433.98
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 171.52 changed to 162.77
- Malpractice RVU 1.57 changed to 1.62
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$5667.99changed to$5746.06
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 160.37 changed to 171.52
- Malpractice RVU 1.56 changed to 1.57
- Practice expense GPCI 0.890 changed to 0.877
- Malpractice GPCI 0.464 changed to 0.416
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$5765.32changed to$5667.99
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 161.42 changed to 160.37
- Malpractice RVU 1.51 changed to 1.56
- Practice expense GPCI 0.902 changed to 0.890
- Malpractice GPCI 0.512 changed to 0.464
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$6638.80changed to$5765.32
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 188.52 changed to 161.42
- Malpractice RVU 1.50 changed to 1.51
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$6504.44changed to$6638.80
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 185.41 changed to 188.52
- Malpractice RVU 1.51 changed to 1.50
- Practice expense GPCI 0.900 changed to 0.902
- Malpractice GPCI 0.510 changed to 0.512
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$6475.60changed to$6504.44
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 185.36 changed to 185.41
- Malpractice RVU 1.59 changed to 1.51
- Practice expense GPCI 0.898 changed to 0.900
- Malpractice GPCI 0.508 changed to 0.510
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$6496.25changed to$6475.60
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 185.27 changed to 185.36
- Malpractice RVU 1.60 changed to 1.59
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$6463.92changed to$6496.25
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$6154.81changed to$6463.92
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 175.77 changed to 185.27
- Malpractice RVU 1.30 changed to 1.60
- Practice expense GPCI 0.896 changed to 0.898
- Malpractice GPCI 0.556 changed to 0.508
Held through RVU15B.
January 1, 2014
RVU14A
$6334.55changed to$6154.81
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 192.13 changed to 175.77
- Malpractice RVU 1.36 changed to 1.30
- Practice expense GPCI 0.894 changed to 0.896
- Malpractice GPCI 0.603 changed to 0.556
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $6334.55
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $5,246.39 | $643.52 | RVU26D |
| 2026-07-01 | $5,246.39 | $643.52 | RVU26C |
| 2026-04-01 | $5,246.39 | $643.52 | RVU26B |
| 2026-01-01 | $5,246.39 | $643.52 | RVU26A |
| 2025-10-01 | $4,805.05 | $692.58 | RVU25D |
| 2025-07-01 | $4,805.05 | $692.58 | RVU25C |
| 2025-04-01 | $4,805.05 | $692.58 | RVU25B |
| 2025-01-01 | $4,805.05 | $692.58 | RVU25A |
| 2024-10-01 | $5,160.80 | $707.44 | RVU24D |
| 2024-07-01 | $5,160.80 | $707.44 | RVU24C |
| 2024-04-01 | $5,160.80 | $707.44 | RVU24B |
| 2024-03-09 | $5,160.80 | $707.44 | RVU24AR |
| 2024-01-01 | $5,076.57 | $695.89 | RVU24A |
| 2023-10-01 | $5,256.72 | $707.24 | RVU23D |
| 2023-07-01 | $5,256.72 | $707.24 | RVU23C |
| 2023-04-01 | $5,256.72 | $707.24 | RVU23B |
| 2023-01-01 | $5,256.72 | $707.24 | RVU23A |
| 2022-10-01 | $5,433.98 | $710.66 | RVU22D |
| 2022-07-01 | $5,433.98 | $710.66 | RVU22C |
| 2022-04-01 | $5,433.98 | $710.66 | RVU22B |
| 2022-01-01 | $5,433.98 | $710.66 | RVU22A |
| 2021-10-01 | $5,746.06 | $714.91 | RVU21D |
| 2021-07-01 | $5,746.06 | $714.91 | RVU21C |
| 2021-04-01 | $5,746.06 | $714.91 | RVU21B |
| 2021-01-01 | $5,746.06 | $714.91 | RVU21A |
| 2020-10-01 | $5,667.99 | $738.57 | RVU20D |
| 2020-07-01 | $5,667.99 | $738.57 | RVU20C |
| 2020-04-01 | $5,667.99 | $738.57 | RVU20B |
| 2020-01-01 | $5,667.99 | $738.57 | RVU20A |
| 2019-10-01 | $5,765.32 | $745.55 | RVU19D |
| 2019-07-01 | $5,765.32 | $745.55 | RVU19C |
| 2019-04-01 | $5,765.32 | $745.55 | RVU19B |
| 2019-01-01 | $5,765.32 | $745.55 | RVU19A |
| 2018-10-01 | $6,638.80 | $746.17 | RVU18D |
| 2018-07-01 | $6,638.80 | $746.17 | RVU18C |
| 2018-04-01 | $6,638.80 | $746.17 | RVU18B |
| 2018-01-01 | $6,638.80 | $746.17 | RVU18AR1 |
| 2017-10-01 | $6,504.44 | $740.53 | RVU17D |
| 2017-07-01 | $6,504.44 | $740.53 | RVU17C |
| 2017-04-01 | $6,504.44 | $740.53 | RVU17B |
| 2017-01-01 | $6,504.44 | $740.53 | RVU17A |
| 2016-10-01 | $6,475.60 | $737.07 | RVU16D |
| 2016-07-01 | $6,475.60 | $737.07 | RVU16C |
| 2016-04-01 | $6,475.60 | $737.07 | RVU16B |
| 2016-01-01 | $6,475.60 | $737.07 | RVU16A |
| 2015-10-01 | $6,496.25 | $738.62 | RVU15D |
| 2015-07-01 | $6,496.25 | $738.62 | RVU15C |
| 2015-04-01 | $6,463.92 | $734.94 | RVU15B |
| 2015-01-01 | $6,463.92 | $734.94 | RVU15A |
| 2014-10-01 | $6,154.81 | $731.66 | RVU14D |
| 2014-07-01 | $6,154.81 | $731.66 | RVU14C |
| 2014-04-01 | $6,154.81 | $731.66 | RVU14B |
| 2014-01-01 | $6,154.81 | $731.66 | RVU14A |
| 2013-10-01 | $6,334.55 | $708.70 | RVU13D |
| 2013-07-01 | $6,334.55 | $708.70 | RVU13C |
| 2013-04-01 | $6,334.55 | $708.70 | RVU13B |
| 2013-01-01 | $6,334.55 | $708.70 | RVU13AR |
Where the Idaho rate applies
Idaho is a Medicare payment area, not a city. Our Census mapping connects it to 235 cities and communities in Idaho. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Acequia
- Albion
- American Falls
- Ammon
- Arbon Valley
- Arco
- Arimo
55873 billing questions
How does this differ from prostate HIFU ablation?
This code is for cryotherapy, which destroys tissue by freezing. HIFU uses focused ultrasound energy and is reported with the code specific to that technique.
Can ultrasound guidance be billed separately?
Ultrasound guidance and monitoring are included in the cryoablation service. Do not separately report them for guidance or monitoring integral to this procedure.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can modifier 50 or an assistant-at-surgery modifier be used?
Modifier 50 is inappropriate for this prostate procedure. Medicare does not pay an assistant at surgery for this service.
What should the operative note support?
Document the prostate condition treated, the extent of tissue targeted, probe placement, and the cryotherapy performed. The record should also support that the treatment used freezing rather than another ablation method.
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.
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