Billing code 55881: Prostate ablationMedicare rate & RVUs
Reports transurethral thermal ultrasound ablation of prostate tissue, with imaging guidance included when performed, rather than transrectal HIFU or another ablation method.
Medicare pays $9,270.42 for 55881 nationally in the office and $429.54 in a hospital or facility. Local office rates run $7,994.07–$13,224.41.
Medicare rate · 55881
Prostate ablation
Swap in your local Medicare rate.
- Work RVUs
- 9.56
- Total RVUs
- 277.55
- Global days
- 000
National rate · 2026
$9,270.42
Office setting, before claim adjustments.
See every locality for 55881 → · 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
What 55881 covers
A urologist delivers thermal ultrasound to prostate tissue through a transurethral device to ablate the targeted tissue. The procedure is typically performed in a hospital or ambulatory surgical setting; imaging guidance used during treatment is part of the service when performed. The operative record should identify the ablation method and document the treated prostate tissue and treatment session.
Report 55881 for the transurethral thermal ultrasound approach, not for transrectal HIFU or prostate removal. Imaging guidance performed as part of the ablation is included. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery 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 55881 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
$7994.07 to $13224.41
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $8,138.73 | $402.96 |
| Alaska* | $9,990.61 | $575.07 |
| Arizona | $8,988.26 | $421.44 |
| Arkansas | $7,994.07 | $399.75 |
| Atlanta | $9,422.26 | $439.92 |
| Austin | $9,783.10 | $429.44 |
| Bakersfield | $10,115.62 | $426.01 |
| Baltimore/Surr. Cntys | $9,935.75 | $449.48 |
| Beaumont | $8,465.61 | $420.40 |
| Brazoria | $9,183.68 | $422.36 |
| Chicago | $9,370.84 | $485.75 |
| Chico | $10,111.96 | $422.35 |
| Colorado | $9,835.40 | $428.70 |
| Connecticut | $9,971.55 | $449.92 |
| Dallas | $9,231.77 | $426.25 |
| Dc + Md/Va Suburbs | $10,878.27 | $463.71 |
| Delaware | $9,160.92 | $426.12 |
| Detroit | $8,986.99 | $455.54 |
| East St. Louis | $8,599.64 | $466.03 |
| El Centro | $10,112.17 | $422.56 |
| Fort Lauderdale | $9,419.71 | $463.90 |
| Fort Worth | $9,143.22 | $426.10 |
| Fresno | $10,111.96 | $422.35 |
| Galveston | $9,203.48 | $424.48 |
| Hanford-Corcoran | $10,111.96 | $422.35 |
| Hawaii, Guam | $10,473.61 | $421.53 |
| Houston | $9,226.18 | $447.18 |
| Idaho | $8,535.82 | $402.20 |
| Indiana | $8,598.72 | $403.22 |
| Iowa | $8,488.12 | $398.71 |
| Kansas | $8,394.55 | $402.39 |
| Kentucky | $8,277.92 | $418.38 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $10,900.07 | $441.30 |
| Madera | $10,111.96 | $422.35 |
| Manhattan | $10,758.50 | $485.39 |
| Merced | $10,111.96 | $422.35 |
| Metropolitan Boston | $11,007.44 | $451.42 |
| Metropolitan Kansas City | $8,725.98 | $424.39 |
| Metropolitan Philadelphia | $9,649.46 | $446.10 |
| Metropolitan St. Louis | $8,842.84 | $426.32 |
| Miami | $9,699.04 | $495.68 |
| Minnesota | $9,499.64 | $402.37 |
| Mississippi | $8,021.16 | $409.16 |
| Modesto | $10,111.96 | $422.35 |
| Montana** | $9,270.34 | $429.45 |
| Napa | $12,103.44 | $451.16 |
| Nebraska | $8,558.61 | $398.48 |
| Nevada** | $9,272.41 | $422.69 |
| New Hampshire | $9,630.54 | $427.18 |
| New Mexico | $8,539.24 | $432.15 |
| New Orleans | $8,750.38 | $431.11 |
| North Carolina | $8,658.52 | $409.97 |
| North Dakota** | $9,245.82 | $404.93 |
| Northern Nj | $10,718.90 | $463.48 |
| Nyc Suburbs/Long Island | $11,010.28 | $498.47 |
| Ohio | $8,495.61 | $423.88 |
| Oklahoma | $8,307.85 | $412.94 |
| Oxnard-Thousand Oaks-Ventura | $10,885.31 | $435.38 |
| Portland | $10,253.90 | $431.68 |
| Poughkpsie/N Nyc Suburbs | $10,139.91 | $459.14 |
| Puerto Rico | $9,367.81 | $429.67 |
| Queens | $10,930.73 | $480.80 |
| Redding | $10,111.96 | $422.35 |
| Rest Of California | $10,111.96 | $422.35 |
| Rest Of Florida | $8,899.23 | $447.34 |
| Rest Of Georgia | $8,316.13 | $430.06 |
| Rest Of Illinois | $8,518.59 | $446.87 |
| Rest Of Louisiana | $8,244.07 | $419.88 |
| Rest Of Maine | $8,541.99 | $408.38 |
| Rest Of Maryland | $9,377.13 | $430.16 |
| Rest Of Massachusetts | $9,739.33 | $429.88 |
| Rest Of Michigan | $8,500.62 | $428.89 |
| Rest Of Missouri | $8,039.81 | $418.96 |
| Rest Of New Jersey | $10,106.90 | $452.66 |
| Rest Of New York | $8,812.63 | $413.79 |
| Rest Of Oregon | $9,222.48 | $416.96 |
| Rest Of Pennsylvania | $8,537.55 | $421.62 |
| Rest Of Texas | $8,812.01 | $422.01 |
| Rest Of Washington | $9,736.89 | $427.43 |
| Rhode Island | $9,566.03 | $433.40 |
| Riverside-San Bernardino-Ontario | $10,125.41 | $435.80 |
| Sacramento-Roseville-Folsom | $10,714.98 | $433.03 |
| Salinas | $10,677.74 | $431.16 |
| San Diego-Chula Vista-Carlsbad | $11,007.33 | $433.63 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $12,931.32 | $465.67 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $12,929.91 | $464.27 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $13,224.41 | $475.85 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $13,218.65 | $470.10 |
| San Luis Obispo-Paso Robles | $10,495.08 | $425.31 |
| Santa Cruz-Watsonville | $11,173.49 | $431.82 |
| Santa Maria-Santa Barbara | $10,739.15 | $430.68 |
| Santa Rosa-Petaluma | $11,292.19 | $435.59 |
| Seattle (King Cnty) | $11,301.31 | $453.54 |
| South Carolina | $8,587.07 | $418.09 |
| South Dakota** | $9,242.92 | $402.03 |
| Southern Maine | $9,174.95 | $413.63 |
| Stockton | $10,111.96 | $422.35 |
| Suburban Chicago | $9,545.19 | $465.60 |
| Tennessee | $8,440.46 | $404.10 |
| Utah | $8,731.61 | $421.18 |
| Vallejo | $12,101.41 | $449.13 |
| Vermont | $9,160.86 | $408.39 |
| Virgin Islands | $9,367.81 | $429.67 |
| Virginia | $9,106.78 | $416.19 |
| Visalia | $10,111.96 | $422.35 |
| West Virginia | $8,121.10 | $438.37 |
| Wisconsin | $8,867.55 | $397.99 |
| Wyoming** | $9,259.65 | $418.77 |
| Yuba City | $10,111.96 | $422.35 |
55881 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.
$7,994.07
$11,668.19
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $9,990.61 | 1 |
| AL | $8,138.73 | 1 |
| AR | $7,994.07 | 1 |
| AZ | $8,988.26 | 1 |
| CA | $10,111.96–$13,224.41 | 29 |
| CO | $9,835.40 | 1 |
| CT | $9,971.55 | 1 |
| DC | $10,878.27 | 1 |
| DE | $9,160.92 | 1 |
| FL | $8,899.23–$9,699.04 | 3 |
| GA | $8,316.13–$9,422.26 | 2 |
| GU | $10,473.61 | 1 |
| HI | $10,473.61 | 1 |
| IA | $8,488.12 | 1 |
| ID | $8,535.82 | 1 |
| IL | $8,518.59–$9,545.19 | 4 |
| IN | $8,598.72 | 1 |
| KS | $8,394.55 | 1 |
| KY | $8,277.92 | 1 |
| LA | $8,244.07–$8,750.38 | 2 |
| MA | $9,739.33–$11,007.44 | 2 |
| MD | $9,377.13–$10,878.27 | 3 |
| ME | $8,541.99–$9,174.95 | 2 |
| MI | $8,500.62–$8,986.99 | 2 |
| MN | $9,499.64 | 1 |
| MO | $8,039.81–$8,842.84 | 3 |
| MS | $8,021.16 | 1 |
| MT | $9,270.34 | 1 |
| NC | $8,658.52 | 1 |
| ND | $9,245.82 | 1 |
| NE | $8,558.61 | 1 |
| NH | $9,630.54 | 1 |
| NJ | $10,106.90–$10,718.90 | 2 |
| NM | $8,539.24 | 1 |
| NV | $9,272.41 | 1 |
| NY | $8,812.63–$11,010.28 | 5 |
| OH | $8,495.61 | 1 |
| OK | $8,307.85 | 1 |
| OR | $9,222.48–$10,253.90 | 2 |
| PA | $8,537.55–$9,649.46 | 2 |
| PR | $9,367.81 | 1 |
| RI | $9,566.03 | 1 |
| SC | $8,587.07 | 1 |
| SD | $9,242.92 | 1 |
| TN | $8,440.46 | 1 |
| TX | $8,465.61–$9,783.10 | 8 |
| UT | $8,731.61 | 1 |
| VA | $9,106.78–$10,878.27 | 2 |
| VI | $9,367.81 | 1 |
| VT | $9,160.86 | 1 |
| WA | $9,736.89–$11,301.31 | 2 |
| WI | $8,867.55 | 1 |
| WV | $8,121.10 | 1 |
| WY | $9,259.65 | 1 |
How the 55881 rate is calculated
Each of 55881’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 · 55881
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 9.56Practice expense 266.75Malpractice 1.24
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 55881
The CMS indicators that decide how 55881 is paid alongside other services.
CMS payment indicators · 55881
Prostate ablation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
55881 without 51 · national office
$9,270.42
Prostate ablation
55881-51 · Second procedure: 50%
$4,635.21
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%).
55881 compared with similar codes
Compare codes
55881 vs 55880 vs 55873 vs 55877: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 55880Prostate HIFU
- Use 55881 for the transurethral thermal ultrasound approach. Code 55880 describes transrectal high-intensity focused ultrasound ablation.
- 55873Prostate cryoablation
- Code 55873 represents prostate cryoablation; 55881 uses thermal ultrasound delivered transurethrally.
- 55877Prostate ablation
- Code 55877 describes percutaneous irreversible electroporation. Select 55881 when the documented technique is transurethral thermal ultrasound.
55881 billing questions
How is 55881 different from 55880?
55881 describes transurethral thermal ultrasound ablation. Code 55880 is for prostate ablation using high-intensity focused ultrasound delivered transrectally.
Can imaging guidance be billed separately?
Imaging guidance performed as part of the transurethral thermal ultrasound ablation is included in 55881.
Should modifier 50 be appended for treatment on both sides?
No. Modifier 50 is inappropriate for this service; the code is not reported as a bilateral procedure.
Is an assistant at surgery payable?
No. Medicare's statutory restriction bars assistant-at-surgery payment for 55881.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full; other procedures in that session are subject to the standard multiple-procedure reduction.
What documentation supports reporting 55881?
Document the transurethral thermal ultrasound technique, the prostate tissue treated, and the procedure performed. The record should distinguish this approach from transrectal HIFU and other prostate ablation methods.
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
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