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Billing code 55725: Abscess drainageMedicare rate & RVUs

Reports operative drainage of a prostate abscess through a transurethral route, typically performed by a urologist in a surgical setting.

CMS RVU26DEffective Oct 1, 2026109 payment localities17 Medicare services in 2024

Medicare pays $546.77 for 55725 nationally in a facility.

Medicare rate · 55725

Abscess drainage

Work RVUs
9.8
Total RVUs
16.37
Global days
090

National rate · 2026

$546.77

Facility setting, before claim adjustments.

See every locality for 55725 →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 55725 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 55725 covers

A urologist uses a transurethral route to drain an abscess within the prostate. The procedure treats an established infection and collection; it is distinct from taking prostate tissue for cancer diagnosis. It is generally performed in a surgical setting when operative drainage is needed, with the operative report identifying the abscess and the route used to reach and drain it.

Report this code when the documented procedure is transurethral drainage, rather than drainage by another approach. The record should support the abscess diagnosis, operative findings, access route, and drainage performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. An assistant at surgery may be paid; 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 55725 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

55725 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$506.23
Alaska*Unavailable$702.90
ArizonaUnavailable$535.18
ArkansasUnavailable$501.24
AtlantaUnavailable$559.11
AustinUnavailable$552.86
BakersfieldUnavailable$553.40
Baltimore/Surr. CntysUnavailable$574.99
BeaumontUnavailable$527.83
BrazoriaUnavailable$538.47

55725 rates by state

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

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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
55725 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 55725 rate is calculated

Each of 55725’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 · 55725

RVUs × geographic indexes × conversion factor

Work9.80

9.80 RVUs× 1.000 GPCI

Practice expense5.30

5.30 RVUs× 1.000 GPCI

Malpractice1.27

1.27 RVUs× 1.000 GPCI

Adjusted RVUs

16.3700

Conversion factor

$33.4009

Medicare rate

$546.77

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

Payment rules and modifiers for 55725

55725 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 55725

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 · 55725

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

55725 without 51 · national facility

$546.77

Abscess drainage

55725-51 · Second procedure: 50%

$273.39

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

55725 compared with similar codes

Compare codes · National

55725 vs 55720 vs 55705: Medicare rates

  • 55725

    Abscess drainage9.8 wRVU

    Not priced

  • 55720

    Abscess drainage7.54 wRVU

    Not priced

  • 55705

    Prostate biopsy1.88 wRVU

    $233.14

How to choose

55720Abscess drainage
Both codes address prostate abscess drainage. This code is specific to the transurethral route; 55720 is used for drainage by another approach.
55705Prostate biopsy
This code treats a prostate abscess by drainage. 55705 describes an incisional prostate biopsy for tissue diagnosis.

Codes related to 55725

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

Codes related to 55725
CodeHow it relatesNational office range
Used instead
55720Abscess drainageProstate abscess drainage by a different approach; select according to the operative route.No office rate

55725 billing questions

How does this code differ from 55720?

Both codes describe drainage of a prostate abscess, but this code is for the transurethral approach. Use the code that matches the operative route documented.

Can a prostate biopsy code be reported for abscess drainage?

No. Biopsy codes describe obtaining prostate tissue for examination; this service describes operative drainage of an abscess.

How does the multiple-procedure reduction affect other procedures performed in the same session?

Medicare pays the highest-valued procedure in full and applies the standard 50% reduction to the other procedures in that session.

What documentation supports reporting this service?

Document the prostate abscess, the transurethral route, operative findings, and the drainage performed. The operative report should make the approach clear when distinguishing this code from 55720.

What postoperative care is included in the global period?

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

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 55725PPRRVU2026_Oct_nonQPP.csv, line 6,373 (RVU26D)

Open CMS sourceHow we calculate rates

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