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Billing code 55840: Radical prostatectomyMedicare rate & RVUs

Reports open retropubic removal of the prostate for radical treatment, with or without nerve sparing, when the separately defined lymphadenectomy variants are not performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities967 Medicare services in 2024

Medicare pays $1,045.11 for 55840 nationally in a facility.

Medicare rate · 55840

Radical prostatectomy

Swap in your local Medicare rate.

Work RVUs
20.83
Total RVUs
31.29
Global days
090

National rate · 2026

$1,045.11

Facility setting, before claim adjustments.

See every locality for 55840 → · 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 55840 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 55840 covers

A urologist typically performs this open operation through a lower abdominal incision to remove the prostate as radical treatment, commonly for prostate cancer. Nerve-sparing dissection may be performed when clinically appropriate. This code identifies the retropubic approach without the bilateral pelvic lymphadenectomy variants in the same code family; the operative report should support the approach, extent of prostate removal, and whether nerve sparing was performed.

Report the code when the documented operation matches the open retropubic radical procedure, rather than a perineal or laparoscopic approach or a lymphadenectomy variant. CMS assigns a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%. 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 55840 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

55840 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$973.37
Alaska*Unavailable$1,369.00
ArizonaUnavailable$1,024.02
ArkansasUnavailable$964.60
AtlantaUnavailable$1,069.60
AustinUnavailable$1,051.14
BakersfieldUnavailable$1,047.63
Baltimore/Surr. CntysUnavailable$1,096.65
BeaumontUnavailable$1,015.40
BrazoriaUnavailable$1,028.37

55840 rates by state

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

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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
55840 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 55840 rate is calculated

Each of 55840’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 · 55840

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 20.83Practice expense 7.74Malpractice 2.72

31.2900 adjusted RVUs×$33.4009 conversion factor=$1,045.11

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

Payment rules and modifiers for 55840

55840 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 55840

Radical 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 · 55840

Radical 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

55840 without 51 · national facility

$1,045.11

Radical prostatectomy

55840-51 · Second procedure: 50%

$522.56

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

55840 compared with similar codes

Compare codes

55840 vs 55810 vs 55842 vs 55866: national Medicare rates

Swap in your local Medicare rate.

  • 55840
    Radical prostatectomy · 20.83 wRVU
    —
  • 55810
    Radical prostatectomy · 23.68 wRVU
    —
  • 55842
    Radical prostatectomy · 20.83 wRVU
    —
  • 55866
    Prostatectomy · 21.9 wRVU
    —

How to choose

55810Radical prostatectomy
This code is for the open retropubic approach. Choose 55810 when the radical prostatectomy is performed through the perineal approach.
55842Radical prostatectomy
Both are retropubic radical prostatectomy codes; 55842 identifies the variant that includes bilateral pelvic lymphadenectomy.
55866Prostatectomy
55866 describes laparoscopic radical prostatectomy. Use 55840 for the open retropubic operation.

Codes related to 55840

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

Codes related to 55840
CodeHow it relatesNational office range
Same family
55842Radical prostatectomyRetropubic radical prostatectomy variant that includes bilateral pelvic lymphadenectomy.No office rate
55845Radical prostatectomyRelated retropubic radical prostatectomy variant with pelvic lymphadenectomy.No office rate
Used instead
55810Radical prostatectomyRadical prostatectomy through the perineal rather than retropubic approach.No office rate
55866ProstatectomyLaparoscopic radical prostatectomy rather than an open retropubic operation.No office rate

55840 billing questions

How is this code distinguished from 55810?

Both describe radical prostatectomy, but 55840 is the open retropubic approach and 55810 is the perineal approach. Use the approach documented in the operative report.

Which code applies when bilateral pelvic lymphadenectomy is performed?

Use the applicable lymphadenectomy variant in the 55840 family, such as 55842 or 55845, rather than reporting 55840 for that operative configuration.

Does nerve sparing change the code selection?

No. This code includes the retropubic radical procedure whether or not nerve-sparing dissection is performed.

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.

Can an assistant or co-surgeon be reported?

CMS may pay for an assistant at surgery. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

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 55840PPRRVU2026_Oct_nonQPP.csv, line 6,380 (RVU26D)

Open CMS sourceHow we calculate rates

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