CPT code 55874: Prostate spacer, biodegradable material2026 Medicare rate & RVUs in Vermont

In Vermont, Medicare pays $3,663.10 for 55874 in the office and $136.85 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 55874 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 55874 covers

A urologist typically places biodegradable material, often a hydrogel spacer, in the tissue plane between the prostate and rectum before prostate radiation therapy. The added separation can help limit radiation exposure to the rectum. Placement is performed through the perineum with image guidance, commonly in an outpatient or hospital setting. The service may involve one or multiple deposits of material during the procedure.

Report 55874 for the spacer placement, including image guidance when performed; the code covers single or multiple placements in the session. The record should support the indication, transperineal placement, material used, and procedural details. It has a 0-day global period, so same-day preoperative and postoperative care is included. For procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery; co-surgeon or team-surgery payment requires supporting documentation.

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 Vermont compares for 55874

Across 109 of 109 payment localities, the office rate for 55874 runs from $3,192.26 in Arkansas to $5,299.18 in San Benito County, CA. Vermont pays $3,663.10. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

55874 rates by state

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

See 55874 in every payment locality

How the 55874 rate is calculated

Each of 55874’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 55874

The CMS indicators that decide how 55874 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

Codes related to 55874

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

How 55874 has changed in Vermont

Price 55874 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

• Albany
• Alburgh
• Algiers
• Arlington
• Ascutney
• Bakersfield
• Barnet
• Barre

Browse all communities in Vermont

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