Billing code 55710: Prostate biopsyMedicare rate & RVUs

Medicare pays $652.32 for 55710 nationally in the office and $188.38 in a hospital or facility. Local office rates run $572.77–$883.87.

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

What 55710 covers

A urologist uses a transperineal needle route to sample a prostate target while ultrasound images are fused with MRI images for targeting. The service is typically performed in an office-based procedure setting or an outpatient facility. The MRI fusion helps direct the needle toward a lesion identified on prior imaging, rather than relying only on systematic sampling.

Report this code for the first lesion sampled with this transperineal ultrasound-and-MRI fusion technique. Document the transperineal route, fusion guidance, target and lesion count; the fusion and ultrasound guidance are part of the biopsy service. The procedure has 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% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires medical-necessity documentation; 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 55710 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

55710 rates by state

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

How the 55710 rate is calculated

Each of 55710’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 55710

The CMS indicators that decide how 55710 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

55710 compared with similar codes

How to choose

55709Prostate biopsy

Choose 55709 for transperineal ultrasound-guided biopsy without MRI fusion. Choose 55710 when MRI images are fused with ultrasound to target the biopsy.

55708Prostate biopsy

Both involve MRI fusion, but 55708 uses a transrectal needle route. 55710 is for the transperineal route.

55711Prostate biopsy

55711 describes MRI-ultrasound fusion biopsy through a transrectal route. 55710 is the transperineal route.

Codes related to 55710

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