CPT 55707: Prostate biopsyMedicare rate & RVUs

Medicare pays $342.03 for 55707 nationally in the office and $136.28 in a hospital or facility. Local office rates run $302.16–$453.44.

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

What 55707 covers

A urologist typically uses a transrectal ultrasound probe to visualize the prostate and guide a needle that collects tissue cores. The procedure is commonly performed in an office or outpatient setting when prostate cancer is suspected, such as after an elevated prostate-specific antigen result or an abnormal digital rectal examination. The ultrasound-guided transrectal approach distinguishes this service from biopsies performed without imaging, by another route, or with MRI fusion.

Select the code when the documented biopsy uses the transrectal route and ultrasound guidance; the procedure note should support the approach and imaging method. The 0-day global period includes same-day preoperative and postoperative care. If other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery 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 55707 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

55707 rates by state

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

How the 55707 rate is calculated

Each of 55707’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 55707

The CMS indicators that decide how 55707 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

55707 compared with similar codes

How to choose

55705Prostate biopsy

Use 55707 when ultrasound guides a transrectal biopsy. Use 55705 when the biopsy is performed without imaging guidance.

55706Prostate biopsy

55706 identifies transrectal saturation sampling. 55707 is selected for a transrectal biopsy guided by ultrasound when saturation sampling is not the defining method.

55708Prostate biopsy

55708 is the transrectal ultrasound-guided option with MRI fusion. Report 55707 for ultrasound-guided transrectal sampling without MRI fusion.

55709Prostate biopsy

Both involve ultrasound guidance, but 55709 uses the transperineal route; 55707 uses the transrectal route.

Codes related to 55707

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

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