FeeBase
Log inGet started
Menu

CPT code 55876: Prostate markers, radiation guidance devices2026 Medicare rate & RVUs in Utah

Needle placement of prostate fiducial markers or dosimeters to support image localization during planned radiation treatment.

CMS RVU26DEffective Oct 1, 2026One payment locality27.4K Medicare services in 2024

In Utah, Medicare pays $145.35 for 55876 in the office and $88.52 when it’s performed in a hospital or facility.

$145.35Office (non-facility)
$88.52Hospital or facility
−3.9%vs the national office rate ($151.31)

Check a contract rate as a % of Medicare · 55876 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 55876 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Utah
  2. What 55876 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 55876 covers

This service places one or more small interstitial devices, such as fiducial markers or a dosimeter, in the prostate to help localize the gland during radiation treatment. A urologist or other qualified physician typically performs the needle-based procedure, often with imaging guidance, in an office or facility. The needle approach may vary; the purpose is radiation guidance rather than delivery of radioactive seeds or removal of prostate tissue.

Report one service for the marker-placement session; the code includes single or multiple devices. The record should identify the prostate as the target, the devices placed, and their radiation-guidance purpose. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. 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% multiple-procedure reduction. Modifier 50 is inappropriate for this prostate service. 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 Utah compares for 55876

Across 109 of 109 payment localities, the office rate for 55876 runs from $135.75 in Arkansas to $193.69 in San Benito County, CA. Utah pays $145.35. The RVUs are the same everywhere; the geographic indexes change the dollars.

55876 in Utah vs other payment areas
  1. Utah · this page$145.35
  2. Los Angeles, CA · California$167.69+$22.34
  3. Washington, DC area · District of Columbia$170.83+$25.48
  4. Miami, FL · Florida$164.64+$19.29
  5. Chicago, IL · Illinois$160.36+$15.01
  6. Manhattan, NY · New York$172.98+$27.63
  7. Alaska · Alaska$182.43+$37.08

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

Every other payment area

55876 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$137.49$84.59
ArkansasArkansas$135.75$83.82
ArizonaArizona$147.65$89.07
Bakersfield, CACalifornia$158.39$92.14
Chico, CACalifornia$157.82$91.56
El Centro, CACalifornia$157.85$91.59
Fresno, CACalifornia$157.82$91.56
Hanford, CACalifornia$157.82$91.56

55876 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$135.75

$182.43

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
55876 office rate range by state
State / territoryOffice rate rangeLocalities
AK$182.431
AL$137.491
AR$135.751
AZ$147.651
CA$157.82–$193.6929
CO$156.261
CT$160.581
DC$170.831
DE$149.891
FL$150.60–$164.643
GA$142.97–$154.172
GU$160.761
HI$160.761
IA$139.961
ID$140.881
IL$147.18–$160.364
IN$141.581
KS$139.661
KY$140.941
LA$140.86–$146.952
MA$155.61–$170.092
MD$152.41–$170.833
ME$141.83–$148.172
MI$144.42–$152.562
MN$149.411
MO$138.93–$147.073
MS$137.351
MT$151.291
NC$143.081
ND$147.541
NE$140.541
NH$154.141
NJ$162.32–$169.462
NM$145.241
NV$150.331
NY$145.00–$177.095
OH$143.661
OK$140.421
OR$149.07–$160.412
PA$143.70–$157.182
PR$152.181
RI$154.611
SC$143.631
SD$147.091
TN$140.311
TX$142.89–$155.838
UT$145.351
VA$147.94–$170.832
VI$152.181
VT$147.291
WA$155.21–$173.062
WI$143.201
WV$142.451
WY$149.661

See 55876 in every payment locality

How the 55876 rate is calculated

Each of 55876’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 · 55876

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.69

1.69 RVUs× 1.000 GPCI

Practice expense2.65

2.65 RVUs× 1.000 GPCI

Malpractice0.19

0.19 RVUs× 1.000 GPCI

Adjusted RVUs

4.5300

Conversion factor

$33.4009

Medicare rate

$151.31

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

The exact Utah inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,394

Code
55876
Physician work
1.69
Practice expense
2.65
Malpractice
0.19

GPCI2026.csv

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Office calculation for 55876 in Utah
ComponentRVULocality factorAdjusted
Physician work1.69× 1.0001.6900
Practice expense2.65× 0.9402.4910
Malpractice0.19× 0.8980.1706
Total RVUs4.3516
Conversion factor× 33.4009

Office rate, Utah$145.35

Office: (1.69 × 1 + 2.65 × 0.94 + 0.19 × 0.898) × $33.4009 = $145.35

Facility: (1.69 × 1 + 0.84 × 0.94 + 0.19 × 0.898) × $33.4009 = $88.52

Open 55876 in the RVU calculator

Payment rules and modifiers for 55876

The CMS indicators that decide how 55876 is paid alongside other services.

CMS payment indicators · 55876

Prostate markers, radiation guidance devices

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is 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)1Not paid (statutory restriction).
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)1Permitted with supporting documentation.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

55876 without 51 · national office

$151.31

Prostate markers, radiation guidance devices

55876-51 · Second procedure: 50%

$75.66

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

Codes related to 55876

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

Codes related to 55876
CodeHow it relatesOffice range, Utah
Often billed with
55874Prostate spacer, biodegradable materialBiodegradable material placement around the prostate may be performed during the same radiation-preparation encounter.$3,487.67
76942Ultrasound needle guidance, biopsy, aspiration, injection, or localizationUltrasound guidance may accompany needle placement, subject to applicable reporting edits.$61.53
Used instead
55875Prostate brachytherapy, needle or catheter placementUsed for prostate needle or catheter placement for interstitial radioactive-element treatment rather than radiation-guidance markers.No office rate

How 55876 has changed in Utah

55876 · Office / nonfacility

$145.35

Effective 2026-10-01

The base rate is $6.72 higher than on 2025-10-01, moving from $138.63 to $145.35 (4.8%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

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, 2026

    RVU26A

    $138.63changed to$145.35

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.73 changed to 1.69
    • Practice expense RVU 2.57 changed to 2.65
    • Malpractice RVU 0.17 changed to 0.19
    • Practice expense GPCI 0.933 changed to 0.940
    • Malpractice GPCI 0.930 changed to 0.898

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $145.15changed to$138.63

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.63 changed to 2.57
    • Malpractice RVU 0.19 changed to 0.17

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $142.78changed to$145.15

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $145.78changed to$142.78

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.60 changed to 2.63
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.865 changed to 0.930

  5. January 1, 2023

    RVU23A

    $146.54changed to$145.78

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.56 changed to 2.60
    • Practice expense GPCI 0.919 changed to 0.926
    • Malpractice GPCI 0.799 changed to 0.865

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $144.63changed to$146.54

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.48 changed to 2.56
    • Malpractice RVU 0.17 changed to 0.19

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $143.76changed to$144.63

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.25 changed to 2.48
    • Malpractice RVU 0.18 changed to 0.17
    • Practice expense GPCI 0.923 changed to 0.919
    • Malpractice GPCI 0.982 changed to 0.799

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $141.40changed to$143.76

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.14 changed to 2.25
    • Practice expense GPCI 0.927 changed to 0.923
    • Malpractice GPCI 1.165 changed to 0.982

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $137.57changed to$141.40

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.03 changed to 2.14

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $135.02changed to$137.57

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.97 changed to 2.03
    • Practice expense GPCI 0.925 changed to 0.927
    • Malpractice GPCI 1.167 changed to 1.165

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $133.85changed to$135.02

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.95 changed to 1.97
    • Practice expense GPCI 0.922 changed to 0.925
    • Malpractice GPCI 1.169 changed to 1.167

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $134.00changed to$133.85

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.94 changed to 1.95

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $133.33changed to$134.00

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $130.96changed to$133.33

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.91 changed to 1.94
    • Malpractice RVU 0.15 changed to 0.18
    • Practice expense GPCI 0.919 changed to 0.922
    • Malpractice GPCI 1.136 changed to 1.169

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $129.06changed to$130.96

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.06 changed to 1.91
    • Malpractice RVU 0.16 changed to 0.15
    • Practice expense GPCI 0.916 changed to 0.919
    • Malpractice GPCI 1.102 changed to 1.136

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $129.06

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$145.35$88.52RVU26D
2026-07-01$145.35$88.52RVU26C
2026-04-01$145.35$88.52RVU26B
2026-01-01$145.35$88.52RVU26A
2025-10-01$138.63$96.38RVU25D
2025-07-01$138.63$96.38RVU25C
2025-04-01$138.63$96.38RVU25B
2025-01-01$138.63$96.38RVU25A
2024-10-01$145.15$98.56RVU24D
2024-07-01$145.15$98.56RVU24C
2024-04-01$145.15$98.56RVU24B
2024-03-09$145.15$98.56RVU24AR
2024-01-01$142.78$96.96RVU24A
2023-10-01$145.78$98.08RVU23D
2023-07-01$145.78$98.08RVU23C
2023-04-01$145.78$98.08RVU23B
2023-01-01$145.78$98.08RVU23A
2022-10-01$146.54$98.20RVU22D
2022-07-01$146.54$98.20RVU22C
2022-04-01$146.54$98.20RVU22B
2022-01-01$146.54$98.20RVU22A
2021-10-01$144.63$97.81RVU21D
2021-07-01$144.63$97.81RVU21C
2021-04-01$144.63$97.81RVU21B
2021-01-01$144.63$97.81RVU21A
2020-10-01$143.76$102.12RVU20D
2020-07-01$143.76$102.12RVU20C
2020-04-01$143.76$102.12RVU20B
2020-01-01$143.76$102.12RVU20A
2019-10-01$141.40$103.31RVU19D
2019-07-01$141.40$103.31RVU19C
2019-04-01$141.40$103.31RVU19B
2019-01-01$141.40$103.31RVU19A
2018-10-01$137.57$103.53RVU18D
2018-07-01$137.57$103.53RVU18C
2018-04-01$137.57$103.53RVU18B
2018-01-01$137.57$103.53RVU18AR1
2017-10-01$135.02$102.82RVU17D
2017-07-01$135.02$102.82RVU17C
2017-04-01$135.02$102.82RVU17B
2017-01-01$135.02$102.82RVU17A
2016-10-01$133.85$101.83RVU16D
2016-07-01$133.85$101.83RVU16C
2016-04-01$133.85$101.83RVU16B
2016-01-01$133.85$101.83RVU16A
2015-10-01$134.00$102.19RVU15D
2015-07-01$134.00$102.19RVU15C
2015-04-01$133.33$101.69RVU15B
2015-01-01$133.33$101.69RVU15A
2014-10-01$130.96$100.01RVU14D
2014-07-01$130.96$100.01RVU14C
2014-04-01$130.96$100.01RVU14B
2014-01-01$130.96$100.01RVU14A
2013-10-01$129.06$96.65RVU13D
2013-07-01$129.06$96.65RVU13C
2013-04-01$129.06$96.65RVU13B
2013-01-01$129.06$96.65RVU13AR

Price 55876 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

  • Alpine
  • Alta
  • Altamont
  • Alton
  • Amalga
  • American Fork
  • Aneth
  • Annabella

Browse all communities in Utah

55876 billing questions

Is this code for fiducial markers or brachytherapy seeds?

Use it for needle placement of prostate markers or a dosimeter to guide radiation localization. Brachytherapy needle or catheter placement is a different service, reported with 55875.

Does one code cover multiple markers?

Yes. The service includes placement of a single device or multiple devices during the session; the number of markers does not create additional units.

Can prostate spacer placement be reported at the same session?

Marker placement and biodegradable material placement around the prostate are distinct services and may occur during the same preparation encounter. Document each service performed.

Should modifier 50 be appended?

No. CMS identifies bilateral adjustment as inappropriate for this prostate service.

How does the 0-day global period affect same-day care?

Same-day preoperative and postoperative care is included in the procedure's 0-day global period.

How are other procedures in the same session paid?

Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the other procedures are subject to a 50% reduction. Medicare does not pay an assistant at surgery; co-surgeon or team-surgery payment requires supporting documentation.

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 55876PPRRVU2026_Oct_nonQPP.csv, line 6,394 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 55876 pays in Utah?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 55876 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist