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Billing code 55831: ProstatectomyMedicare rate & RVUs

Open retropubic subtotal prostatectomy removes obstructing prostate tissue for selected patients with benign enlargement when an open simple-prostatectomy approach is performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities182 Medicare services in 2024

Medicare pays $774.90 for 55831 nationally in a facility.

Medicare rate · 55831

Prostatectomy

Swap in your local Medicare rate.

Work RVUs
15.21
Total RVUs
23.20
Global days
090

National rate · 2026

$774.90

Facility setting, before claim adjustments.

See every locality for 55831 → · 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 55831 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 55831 covers

This open operation removes the obstructing portion of an enlarged prostate through a retropubic approach, leaving the outer prostate capsule rather than removing the gland as a cancer operation. Urologists typically perform it in a hospital operating room for patients with benign prostatic enlargement who need surgical treatment. The operative approach distinguishes this service from subtotal procedures using a perineal or suprapubic route and from radical prostatectomy.

Report 55831 when the operative record supports subtotal removal by the retropubic route. Documentation should identify the indication, surgical approach, and extent of tissue removed. The code includes related services named in its descriptor, such as control of postoperative bleeding, vasectomy, meatotomy, urethral calibration or dilation, and internal urethrotomy when performed as part of the operation. It has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, 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 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 55831 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

55831 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$720.90
Alaska*Unavailable$1,011.93
ArizonaUnavailable$759.08
ArkansasUnavailable$714.29
AtlantaUnavailable$793.05
AustinUnavailable$779.91
BakersfieldUnavailable$777.64
Baltimore/Surr. CntysUnavailable$813.47
BeaumontUnavailable$752.15
BrazoriaUnavailable$762.47

55831 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
55831 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 55831 rate is calculated

Each of 55831’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 · 55831

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 15.21Practice expense 5.99Malpractice 2.00

23.2000 adjusted RVUs×$33.4009 conversion factor=$774.90

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 55831

55831 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 55831

Prostatectomy

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 · 55831

Prostatectomy

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

55831 without 51 · national facility

$774.90

Prostatectomy

55831-51 · Second procedure: 50%

$387.45

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

55831 compared with similar codes

Compare codes

55831 vs 55821 vs 55801 vs 55840 vs 55867: national Medicare rates

Swap in your local Medicare rate.

  • 55831
    Prostatectomy · 15.21 wRVU
    —
  • 55821
    Prostatectomy · 14.8 wRVU
    —
  • 55801
    Prostatectomy · 19.31 wRVU
    —
  • 55840
    Radical prostatectomy · 20.83 wRVU
    —
  • 55867
    Prostatectomy · 19.04 wRVU
    —

How to choose

55821Prostatectomy
Both are subtotal procedures; 55831 uses a retropubic route, while 55821 uses a suprapubic route. Follow the documented operative approach.
55801Prostatectomy
55801 is the perineal subtotal procedure. Use 55831 for subtotal removal performed through a retropubic approach.
55840Radical prostatectomy
55840 describes radical retropubic prostatectomy, not subtotal removal. Select based on whether the operative report documents radical gland removal or a simple/subtotal procedure.
55867Prostatectomy
Both involve simple/subtotal prostate removal, but 55867 is laparoscopic and 55831 is the open retropubic procedure.

Codes related to 55831

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

Codes related to 55831
CodeHow it relatesNational office range
Same family
55801ProstatectomySubtotal prostatectomy by the perineal rather than retropubic approach.No office rate
55821ProstatectomySubtotal prostatectomy by the suprapubic rather than retropubic approach.No office rate
Used instead
55840Radical prostatectomyRadical retropubic prostatectomy, used for a different extent of gland removal.No office rate
55845Radical prostatectomyRadical retropubic prostatectomy with bilateral pelvic lymphadenectomy.No office rate
55867ProstatectomyLaparoscopic simple subtotal prostatectomy, a different operative approach.No office rate

55831 billing questions

How does 55831 differ from 55821?

Both describe subtotal prostate removal, but 55831 is the retropubic approach and 55821 is the suprapubic approach. The operative report must support the route performed.

When would 55801 be reported instead?

55801 describes subtotal prostate removal through a perineal approach. Choose 55831 when the surgeon uses the retropubic route.

Is 55831 a radical prostatectomy?

No. It represents subtotal removal, typically for benign enlargement, rather than radical removal of the prostate for cancer. Radical retropubic surgery is represented by codes such as 55840.

Can associated procedures be billed separately?

Services identified as included in the descriptor—such as control of postoperative bleeding, vasectomy, meatotomy, urethral calibration or dilation, and internal urethrotomy—are part of the operation when performed as related services.

What are the assistant and co-surgeon rules?

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

Does modifier 50 apply, and what is the global period?

Modifier 50 is inappropriate for this procedure. 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 55831PPRRVU2026_Oct_nonQPP.csv, line 6,379 (RVU26D)

Open CMS sourceHow we calculate rates

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