Billing code 55873: Prostate cryoablationMedicare rate & RVUs

Reports prostate tissue destruction by cryotherapy, typically for localized prostate cancer or recurrent disease, with ultrasound guidance and monitoring included.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.3K Medicare services in 2024

Medicare pays $5,691.51 for 55873 nationally in the office and $688.39 in a hospital or facility. Local office rates run $4,932.04–$8,008.98.

Medicare rate · 55873

Prostate cryoablation

Work RVUs
13.26
Total RVUs
170.40
Global days
090

National rate · 2026

$5,691.51

Office setting, before claim adjustments.

See every locality for 55873 →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 55873 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 55873 covers

A urologist uses probes placed through the perineum to freeze prostate tissue, with ultrasound used to guide and monitor treatment. The procedure is commonly performed in a hospital or ambulatory surgery setting for localized prostate cancer, including selected cases treated after recurrence following radiation. The treatment may target the gland or a defined area, depending on the clinical plan.

Report the service when the documented procedure uses cryotherapy to ablate prostate tissue; the operative note should identify the indication, treatment extent, probe placement, and freezing process. Ultrasound guidance and monitoring are included in the service. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that 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 multiple procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing are 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 55873 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$4932.04 to $8008.98

$4932.04$6470.51$8008.98
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

55873 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$5,017.99$640.26
Alaska*$6,225.11$896.78
Arizona$5,522.43$674.40
Arkansas$4,932.04$634.36
Atlanta$5,787.26$704.09
Austin$5,987.11$693.81
Bakersfield$6,176.31$692.89
Baltimore/Surr. Cntys$6,091.01$722.66
Beaumont$5,220.21$667.37
Brazoria$5,635.91$677.82

55873 rates by state

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

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.

$4,932.04

$7,090.14

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
55873 office rate range by state
State / territoryOffice rate rangeLocalities
AK$6,225.111
AL$5,017.991
AR$4,932.041
AZ$5,522.431
CA$6,171.30–$8,008.9829
CO$6,016.761
CT$6,112.021
DC$6,646.011
DE$5,625.721
FL$5,491.45–$5,990.703
GA$5,141.60–$5,787.262
GU$6,379.081
HI$6,379.081
IA$5,216.141
ID$5,246.391
IL$5,271.57–$5,878.384
IN$5,283.471
KS$5,165.071
KY$5,110.381
LA$5,092.04–$5,392.852
MA$5,962.33–$6,710.742
MD$5,753.62–$6,646.013
ME$5,254.80–$5,623.952
MI$5,247.08–$5,548.512
MN$5,802.351
MO$4,973.53–$5,442.403
MS$4,955.071
MT$5,691.401
NC$5,323.261
ND$5,657.981
NE$5,256.611
NH$5,897.341
NJ$6,192.38–$6,554.002
NM$5,271.911
NV$5,687.281
NY$5,415.14–$6,749.555
OH$5,240.251
OK$5,123.361
OR$5,653.98–$6,260.482
PA$5,262.65–$5,923.262
PR$5,747.781
RI$5,865.171
SC$5,288.441
SD$5,654.031
TN$5,192.891
TX$5,220.21–$5,987.118
UT$5,374.231
VA$5,586.65–$6,646.012
VI$5,747.781
VT$5,611.711
WA$5,958.97–$6,881.952
WI$5,434.381
WV$5,035.671
WY$5,676.841

How the 55873 rate is calculated

Each of 55873’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 · 55873

RVUs × geographic indexes × conversion factor

Work13.26

13.26 RVUs× 1.000 GPCI

Practice expense155.45

155.45 RVUs× 1.000 GPCI

Malpractice1.69

1.69 RVUs× 1.000 GPCI

Adjusted RVUs

170.4000

Conversion factor

$33.4009

Medicare rate

$5,691.51

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

Payment rules and modifiers for 55873

55873 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 55873

Prostate cryoablation

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)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.08/0.83/0.09Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 55873

Prostate cryoablation

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

55873 without 51 · national office

$5,691.51

Prostate cryoablation

55873-51 · Second procedure: 50%

$2,845.76

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

55873 compared with similar codes

Compare codes · National

4 codes, side by side

  • 55873

    Prostate cryoablation13.26 wRVU

    $5,691.51

  • 55880

    Prostate HIFU17.29 wRVU

    Not priced

  • 55877

    Prostate ablation13.5 wRVU

    Not priced

  • 55866

    Prostatectomy21.9 wRVU

    Not priced

How to choose

55880Prostate HIFU
Use 55873 for prostate tissue treated by freezing. Code 55880 describes ablation using high-intensity focused ultrasound.
55877Prostate ablation
Use 55873 when cryotherapy is performed. Code 55877 is for percutaneous prostate tumor ablation using irreversible electroporation.
55866Prostatectomy
Code 55866 reports laparoscopic radical removal of the prostate; 55873 reports ablation that leaves the prostate in place.

55873 billing questions

How does this differ from prostate HIFU ablation?

This code is for cryotherapy, which destroys tissue by freezing. HIFU uses focused ultrasound energy and is reported with the code specific to that technique.

Can ultrasound guidance be billed separately?

Ultrasound guidance and monitoring are included in the cryoablation service. Do not separately report them for guidance or monitoring integral to this procedure.

What postoperative care is included?

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

Can modifier 50 or an assistant-at-surgery modifier be used?

Modifier 50 is inappropriate for this prostate procedure. Medicare does not pay an assistant at surgery for this service.

What should the operative note support?

Document the prostate condition treated, the extent of tissue targeted, probe placement, and the cryotherapy performed. The record should also support that the treatment used freezing rather than another ablation method.

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 55873PPRRVU2026_Oct_nonQPP.csv, line 6,391 (RVU26D)

Open CMS sourceHow we calculate rates

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