CPT code 55873: Prostate cryoablation, ultrasound-guided freeze treatment2026 Medicare rate & RVUs in Missouri
Reports prostate tissue destruction by cryotherapy, typically for localized prostate cancer or recurrent disease, with ultrasound guidance and monitoring included.
Medicare pays $4,973.53–$5,442.40 for 55873 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 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.
Where 55873 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$4973.53 to $5442.40
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $5,373.49 | $675.56 |
| Metropolitan St. Louis, MO | $5,442.40 | $679.43 |
| Rest of Missouri | $4,973.53 | $660.84 |
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.
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%).
55873 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 55880Prostate HIFUTransrectal malignant tissue ablation
- Use 55873 for prostate tissue treated by freezing. Code 55880 describes ablation using high-intensity focused ultrasound.
- 55877Prostate ablationIrreversible electroporation, percutaneous
- Use 55873 when cryotherapy is performed. Code 55877 is for percutaneous prostate tumor ablation using irreversible electroporation.
- 55866ProstatectomyLaparoscopic, radical
- Code 55866 reports laparoscopic radical removal of the prostate; 55873 reports ablation that leaves the prostate in place.
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.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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