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Billing code 55720: Abscess drainageMedicare rate & RVUs

Surgical drainage of a prostate abscess by a non-transurethral route, reported when the operative service opens and evacuates the infected collection.

CMS RVU26DEffective Oct 1, 2026109 payment localities30 Medicare services in 2024

Medicare pays $415.17 for 55720 nationally in a facility.

Medicare rate · 55720

Abscess drainage

Work RVUs
7.54
Total RVUs
12.43
Global days
090

National rate · 2026

$415.17

Facility setting, before claim adjustments.

See every locality for 55720 →Billed by an NP, PA or therapist? →

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

On this page 10 sections
  1. Medicare rate
  2. What 55720 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 55720 covers

A urologist uses this service to drain an abscess within the prostate through a non-transurethral route. The operative approach is selected to reach and evacuate the infected collection; the procedure is generally performed in a surgical facility. It is therapeutic drainage, not a prostate biopsy for tissue diagnosis. The transurethral route is represented by a separate code.

Report 55720 when the operative record supports prostate abscess drainage and identifies a non-transurethral approach. Document the abscess, route, operative findings, and drainage performed. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is 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 55720 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

55720 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$384.64
Alaska*Unavailable$534.89
ArizonaUnavailable$406.41
ArkansasUnavailable$380.88
AtlantaUnavailable$424.60
AustinUnavailable$419.52
BakersfieldUnavailable$419.70
Baltimore/Surr. CntysUnavailable$436.49
BeaumontUnavailable$401.10
BrazoriaUnavailable$408.81

55720 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.

View every state and territory as a table
55720 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 55720 rate is calculated

Each of 55720’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 · 55720

RVUs × geographic indexes × conversion factor

Work7.54

7.54 RVUs× 1.000 GPCI

Practice expense3.91

3.91 RVUs× 1.000 GPCI

Malpractice0.98

0.98 RVUs× 1.000 GPCI

Adjusted RVUs

12.4300

Conversion factor

$33.4009

Medicare rate

$415.17

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

Payment rules and modifiers for 55720

55720 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 55720

Abscess drainage

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are 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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 55720

Abscess drainage

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

55720 without 51 · national facility

$415.17

Abscess drainage

55720-51 · Second procedure: 50%

$207.59

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

55720 compared with similar codes

Compare codes · National

55720 vs 55725 vs 55705: Medicare rates

  • 55720

    Abscess drainage7.54 wRVU

    Not priced

  • 55725

    Abscess drainage9.8 wRVU

    Not priced

  • 55705

    Prostate biopsy1.88 wRVU

    $233.14

How to choose

55725Abscess drainage
Both codes describe prostate abscess drainage; select 55725 for the transurethral route and 55720 for a non-transurethral route.
55705Prostate biopsy
55705 describes incisional prostate biopsy, not abscess evacuation. Use 55720 when the operative purpose is drainage.

Codes related to 55720

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

Codes related to 55720
CodeHow it relatesNational office range
Used instead
55725Abscess drainageUse for prostate abscess drainage performed through a transurethral route.No office rate

55720 billing questions

How do I choose between 55720 and 55725?

Use 55720 for prostate abscess drainage by a non-transurethral route. Use 55725 when the drainage is performed transurethrally.

Is this a prostate biopsy code?

No. It reports therapeutic drainage of an abscess. Prostate biopsy codes describe tissue sampling for diagnosis.

What should the operative note document?

Document the prostate abscess, the approach used, operative findings, and the drainage performed. The approach is especially important in distinguishing 55720 from 55725.

Does the code include postoperative care?

The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days after surgery.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, with other procedures subject to the standard multiple-procedure reduction.

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 55720PPRRVU2026_Oct_nonQPP.csv, line 6,372 (RVU26D)

Open CMS sourceHow we calculate rates

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