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Billing code 55845: Radical prostatectomyMedicare rate & RVUs

Reports open retropubic radical prostate removal with bilateral dissection of the external iliac, hypogastric, and obturator lymph-node basins.

CMS RVU26DEffective Oct 1, 2026109 payment localities492 Medicare services in 2024

Medicare pays $1,209.45 for 55845 nationally in a facility.

Medicare rate · 55845

Radical prostatectomy

Swap in your local Medicare rate.

Work RVUs
24.55
Total RVUs
36.21
Global days
090

National rate · 2026

$1,209.45

Facility setting, before claim adjustments.

See every locality for 55845 → · 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 55845 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 55845 covers

A urologist uses an open retropubic approach to remove the prostate for cancer and dissect pelvic lymph nodes on both sides, including the external iliac, hypogastric, and obturator basins. The code fits an operation that includes this extensive nodal dissection, rather than prostate removal alone or a less extensive node dissection. These procedures are generally performed in a hospital operating room.

Report the code when the operative note supports the retropubic approach, radical prostate removal, bilateral dissection, and the specified nodal basins. The bilateral work is built into the code; modifier 50 does not increase payment. The day-before preoperative visit and 90 days of related postoperative care are included in the global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others 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 55845 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

55845 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,128.05
Alaska*Unavailable$1,590.33
ArizonaUnavailable$1,185.41
ArkansasUnavailable$1,118.11
AtlantaUnavailable$1,237.73
AustinUnavailable$1,215.46
BakersfieldUnavailable$1,210.85
Baltimore/Surr. CntysUnavailable$1,268.36
BeaumontUnavailable$1,176.41
BrazoriaUnavailable$1,190.16

55845 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
55845 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 55845 rate is calculated

Each of 55845’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 · 55845

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 24.55Practice expense 8.49Malpractice 3.17

36.2100 adjusted RVUs×$33.4009 conversion factor=$1,209.45

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

Payment rules and modifiers for 55845

55845 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 55845

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)2Already bilateral by definition: paid once at 100%.
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 · 55845

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

55845 without 51 · national facility

$1,209.45

Radical prostatectomy

55845-51 · Second procedure: 50%

$604.73

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

55845 compared with similar codes

Compare codes

55845 vs 55840 vs 55842 vs 55815 vs 55866: national Medicare rates

Swap in your local Medicare rate.

  • 55845
    Radical prostatectomy · 24.55 wRVU
    —
  • 55840
    Radical prostatectomy · 20.83 wRVU
    —
  • 55842
    Radical prostatectomy · 20.83 wRVU
    —
  • 55815
    Radical prostatectomy · 32.13 wRVU
    —
  • 55866
    Prostatectomy · 21.9 wRVU
    —

How to choose

55840Radical prostatectomy
Both describe open retropubic radical prostate removal, but 55840 does not include the extensive bilateral pelvic node dissection represented by 55845.
55842Radical prostatectomy
Use 55842 for a more limited bilateral pelvic node dissection. Use 55845 when the documented dissection includes the external iliac, hypogastric, and obturator basins.
55815Radical prostatectomy
This is the perineal approach with extensive bilateral pelvic node dissection; 55845 is the retropubic approach.
55866Prostatectomy
This code is for laparoscopic radical prostatectomy, including robotic assistance; 55845 describes an open retropubic operation.

Codes related to 55845

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

Codes related to 55845
CodeHow it relatesNational office range
Same family
55840Radical prostatectomyOpen retropubic radical prostate removal without the extensive bilateral nodal dissection represented here.No office rate
55842Radical prostatectomyRetropubic radical prostatectomy with bilateral pelvic node dissection of more limited extent.No office rate
Used instead
55815Radical prostatectomyPerineal rather than retropubic approach, with extensive bilateral pelvic node dissection.No office rate
55866ProstatectomyLaparoscopic approach to radical prostatectomy, including robotic-assisted procedures.No office rate

55845 billing questions

How does this differ from 55842?

55845 is for the more extensive bilateral nodal dissection that includes the external iliac, hypogastric, and obturator basins. Use 55842 when the documented bilateral pelvic dissection is more limited.

Should modifier 50 be added for the bilateral dissection?

No. The code is priced for bilateral work, and modifier 50 does not increase payment.

Can the lymph-node dissection be billed separately?

The bilateral dissection of the specified pelvic basins is included in this procedure. The operative note should establish the extent of nodal work supporting this code.

What postoperative care is included?

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

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted for this code.

How is this distinguished from 55866?

55845 describes an open retropubic operation. Code 55866 is for a laparoscopic radical prostatectomy, including when performed with robotic assistance.

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 55845PPRRVU2026_Oct_nonQPP.csv, line 6,382 (RVU26D)

Open CMS sourceHow we calculate rates

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