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CMS RVU26D · Effective 2026-10-01

53866 in Merced

Office / nonfacility

$152.25

Base rate per service

Facility setting

$73.55

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Urology procedure

About 53866: Cystoscopic removal of prostate remodeling device

Report cystoscopic removal of a temporary prostate remodeling device after treatment for urinary obstruction associated with benign prostatic enlargement.

A urologist uses cystoscopy to retrieve the temporary device previously placed to remodel the prostatic urethra through ischemic effects. The treatment is used for urinary symptoms associated with benign prostatic enlargement; this code describes the removal service, not initial device placement. Removal is generally performed in an outpatient setting after the device has served its intended remodeling purpose.

Report the removal code for the cystoscopic retrieval, supported by documentation identifying the device and recording its removal. Code 53865 describes placement of the device. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.

CMS billing rules for 53866

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU1.44 · 33%
  • Practice expense (office) RVU2.73 · 63%
  • Malpractice RVU0.19 · 4%

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.

53866 compared with similar codes

Office rates for Merced, from the same CMS release.

53865

Prostate remodeling

Temporary implant insertion

$3,367.63

Use 53865 for cystoscopic placement of the temporary remodeling device; use 53866 for its removal.

53850

Prostate treatment

Microwave thermotherapy

$1,537.77

This code describes removal of a remodeling device. Code 53850 represents microwave thermotherapy of prostate tissue.

53854

Prostate ablation

Radiofrequency water vapor

$3,692.23

This code covers cystoscopic device retrieval; 53854 describes prostate tissue treatment using radiofrequency-generated water vapor.

The same code, a different location

How does Merced compare?

In Bakersfield, the office rate for 53866 is $152.81—$0.56 higher than the $152.25 rate in Merced. Both use the same code, release and participation basis.

53866 across payment areas

Same release and payment basis · bars start at $0

  1. Merced · This locality

    $152.25

  2. Bakersfield

    $152.81

    $0.56 higher than Merced

  3. Chico

    $152.25

    The same base rate than Merced

  4. El Centro

    $152.29

    $0.04 higher than Merced

  5. Fresno

    $152.25

    The same base rate than Merced

  6. Hanford-Corcoran

    $152.25

    The same base rate than Merced

  7. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $162.15

    $9.90 higher than Merced

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 53866 ranges from $129.69 in Arkansas to $188.28 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Madera

    California · 53866

    Office

    $152.25

    Facility

    $73.55

    The same base rate than Merced for the office setting.

  • Modesto

    California · 53866

    Office

    $152.25

    Facility

    $73.55

    The same base rate than Merced for the office setting.

  • Napa

    California · 53866

    Office

    $174.53

    Facility

    $79.88

    $22.28 higher than Merced for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 53866

    Office

    $161.18

    Facility

    $76.30

    $8.93 higher than Merced for the office setting.

  • Redding

    California · 53866

    Office

    $152.25

    Facility

    $73.55

    The same base rate than Merced for the office setting.

  • Rest Of California

    California · 53866

    Office

    $152.25

    Facility

    $73.55

    The same base rate than Merced for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 53866

    Office

    $154.31

    Facility

    $75.61

    $2.06 higher than Merced for the office setting.

  • Sacramento-Roseville-Folsom

    California · 53866

    Office

    $159.28

    Facility

    $75.76

    $7.03 higher than Merced for the office setting.

  • Salinas

    California · 53866

    Office

    $158.67

    Facility

    $75.44

    $6.42 higher than Merced for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 53866

    Office

    $162.04

    Facility

    $76.15

    $9.79 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 53866

    Office

    $184.15

    Facility

    $82.89

    $31.90 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 53866

    Office

    $183.93

    Facility

    $82.68

    $31.68 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 53866

    Office

    $188.28

    Facility

    $84.72

    $36.03 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 53866

    Office

    $187.40

    Facility

    $83.84

    $35.15 higher than Merced for the office setting.

  • San Luis Obispo-Paso Robles

    California · 53866

    Office

    $156.18

    Facility

    $74.38

    $3.93 higher than Merced for the office setting.

  • Santa Cruz-Watsonville

    California · 53866

    Office

    $163.30

    Facility

    $76.05

    $11.05 higher than Merced for the office setting.

  • Santa Maria-Santa Barbara

    California · 53866

    Office

    $159.17

    Facility

    $75.43

    $6.92 higher than Merced for the office setting.

  • Santa Rosa-Petaluma

    California · 53866

    Office

    $164.92

    Facility

    $76.73

    $12.67 higher than Merced for the office setting.

  • Stockton

    California · 53866

    Office

    $152.25

    Facility

    $73.55

    The same base rate than Merced for the office setting.

  • Vallejo

    California · 53866

    Office

    $174.22

    Facility

    $79.57

    $21.97 higher than Merced for the office setting.

  • Visalia

    California · 53866

    Office

    $152.25

    Facility

    $73.55

    The same base rate than Merced for the office setting.

  • Yuba City

    California · 53866

    Office

    $152.25

    Facility

    $73.55

    The same base rate than Merced for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 53866

    Office

    $165.17

    Facility

    $80.58

    $12.92 higher than Merced for the office setting.

  • Miami

    Florida · 53866

    Office

    $159.07

    Facility

    $84.31

    $6.82 higher than Merced for the office setting.

  • Chicago

    Illinois · 53866

    Office

    $154.64

    Facility

    $82.47

    $2.39 higher than Merced for the office setting.

  • Manhattan

    New York · 53866

    Office

    $167.20

    Facility

    $83.75

    $14.95 higher than Merced for the office setting.

  • Alaska*

    Alaska · 53866

    Office

    $172.75

    Facility

    $96.27

    $20.50 higher than Merced for the office setting.

  • Alabama

    Alabama · 53866

    Office

    $131.48

    Facility

    $68.64

    $20.77 lower than Merced for the office setting.

  • Arkansas

    Arkansas · 53866

    Office

    $129.69

    Facility

    $68.01

    $22.56 lower than Merced for the office setting.

  • Arizona

    Arizona · 53866

    Office

    $141.89

    Facility

    $72.30

    $10.36 lower than Merced for the office setting.

  • Colorado

    Colorado · 53866

    Office

    $150.65

    Facility

    $74.24

    $1.60 lower than Merced for the office setting.

  • Connecticut

    Connecticut · 53866

    Office

    $154.94

    Facility

    $77.60

    $2.69 higher than Merced for the office setting.

  • Delaware

    Delaware · 53866

    Office

    $144.13

    Facility

    $73.18

    $8.12 lower than Merced for the office setting.

  • Fort Lauderdale

    Florida · 53866

    Office

    $151.94

    Facility

    $79.20

    $0.31 lower than Merced for the office setting.

  • Rest Of Florida

    Florida · 53866

    Office

    $144.81

    Facility

    $76.16

    $7.44 lower than Merced for the office setting.

  • Atlanta

    Georgia · 53866

    Office

    $148.51

    Facility

    $75.55

    $3.74 lower than Merced for the office setting.

  • Rest Of Georgia

    Georgia · 53866

    Office

    $137.00

    Facility

    $72.94

    $15.25 lower than Merced for the office setting.

  • Hawaii, Guam

    Hawaii · 53866

    Office

    $155.45

    Facility

    $73.80

    $3.20 higher than Merced for the office setting.

  • Iowa

    Iowa · 53866

    Office

    $134.05

    Facility

    $68.34

    $18.20 lower than Merced for the office setting.

  • Idaho

    Idaho · 53866

    Office

    $134.99

    Facility

    $68.92

    $17.26 lower than Merced for the office setting.

  • East St. Louis

    Illinois · 53866

    Office

    $144.77

    Facility

    $78.70

    $7.48 lower than Merced for the office setting.

  • Rest Of Illinois

    Illinois · 53866

    Office

    $141.27

    Facility

    $75.70

    $10.98 lower than Merced for the office setting.

  • Suburban Chicago

    Illinois · 53866

    Office

    $153.33

    Facility

    $79.57

    $1.08 higher than Merced for the office setting.

  • Indiana

    Indiana · 53866

    Office

    $135.71

    Facility

    $69.14

    $16.54 lower than Merced for the office setting.

  • Kansas

    Kansas · 53866

    Office

    $133.73

    Facility

    $68.81

    $18.52 lower than Merced for the office setting.

  • Kentucky

    Kentucky · 53866

    Office

    $134.97

    Facility

    $71.13

    $17.28 lower than Merced for the office setting.

  • New Orleans

    Louisiana · 53866

    Office

    $141.11

    Facility

    $73.54

    $11.14 lower than Merced for the office setting.

  • Rest Of Louisiana

    Louisiana · 53866

    Office

    $134.88

    Facility

    $71.32

    $17.37 lower than Merced for the office setting.

  • Metropolitan Boston

    Massachusetts · 53866

    Office

    $164.59

    Facility

    $78.85

    $12.34 higher than Merced for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 53866

    Office

    $149.94

    Facility

    $74.32

    $2.31 lower than Merced for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 53866

    Office

    $154.56

    Facility

    $77.50

    $2.31 higher than Merced for the office setting.

  • Rest Of Maryland

    Maryland · 53866

    Office

    $146.68

    Facility

    $74.01

    $5.57 lower than Merced for the office setting.

  • Rest Of Maine

    Maine · 53866

    Office

    $135.93

    Facility

    $69.87

    $16.32 lower than Merced for the office setting.

  • Southern Maine

    Maine · 53866

    Office

    $142.47

    Facility

    $71.30

    $9.78 lower than Merced for the office setting.

  • Detroit

    Michigan · 53866

    Office

    $146.79

    Facility

    $77.49

    $5.46 lower than Merced for the office setting.

  • Rest Of Michigan

    Michigan · 53866

    Office

    $138.51

    Facility

    $72.95

    $13.74 lower than Merced for the office setting.

  • Minnesota

    Minnesota · 53866

    Office

    $143.80

    Facility

    $69.91

    $8.45 lower than Merced for the office setting.

  • Metropolitan Kansas City

    Missouri · 53866

    Office

    $139.92

    Facility

    $72.49

    $12.33 lower than Merced for the office setting.

  • Metropolitan St. Louis

    Missouri · 53866

    Office

    $141.26

    Facility

    $72.90

    $10.99 lower than Merced for the office setting.

  • Rest Of Missouri

    Missouri · 53866

    Office

    $132.88

    Facility

    $70.98

    $19.37 lower than Merced for the office setting.

  • Mississippi

    Mississippi · 53866

    Office

    $131.30

    Facility

    $69.47

    $20.95 lower than Merced for the office setting.

  • Montana**

    Montana · 53866

    Office

    $145.62

    Facility

    $73.80

    $6.63 lower than Merced for the office setting.

  • North Carolina

    North Carolina · 53866

    Office

    $137.23

    Facility

    $70.23

    $15.02 lower than Merced for the office setting.

  • North Dakota**

    North Dakota · 53866

    Office

    $141.86

    Facility

    $70.05

    $10.39 lower than Merced for the office setting.

  • Nebraska

    Nebraska · 53866

    Office

    $134.66

    Facility

    $68.38

    $17.59 lower than Merced for the office setting.

  • New Hampshire

    New Hampshire · 53866

    Office

    $148.57

    Facility

    $73.82

    $3.68 lower than Merced for the office setting.

  • Northern Nj

    New Jersey · 53866

    Office

    $163.68

    Facility

    $80.38

    $11.43 higher than Merced for the office setting.

  • Rest Of New Jersey

    New Jersey · 53866

    Office

    $156.56

    Facility

    $78.14

    $4.31 higher than Merced for the office setting.

  • New Mexico

    New Mexico · 53866

    Office

    $139.34

    Facility

    $73.48

    $12.91 lower than Merced for the office setting.

  • Nevada**

    Nevada · 53866

    Office

    $144.66

    Facility

    $72.78

    $7.59 lower than Merced for the office setting.

  • Nyc Suburbs/Long Island

    New York · 53866

    Office

    $171.38

    Facility

    $85.99

    $19.13 higher than Merced for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 53866

    Office

    $157.79

    Facility

    $79.15

    $5.54 higher than Merced for the office setting.

  • Queens

    New York · 53866

    Office

    $168.11

    Facility

    $83.23

    $15.86 higher than Merced for the office setting.

  • Rest Of New York

    New York · 53866

    Office

    $139.18

    Facility

    $70.96

    $13.07 lower than Merced for the office setting.

  • Ohio

    Ohio · 53866

    Office

    $137.75

    Facility

    $72.18

    $14.50 lower than Merced for the office setting.

  • Oklahoma

    Oklahoma · 53866

    Office

    $134.46

    Facility

    $70.33

    $17.79 lower than Merced for the office setting.

  • Portland

    Oregon · 53866

    Office

    $154.89

    Facility

    $75.11

    $2.64 higher than Merced for the office setting.

  • Rest Of Oregon

    Oregon · 53866

    Office

    $143.38

    Facility

    $71.85

    $8.87 lower than Merced for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 53866

    Office

    $151.46

    Facility

    $76.70

    $0.79 lower than Merced for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 53866

    Office

    $137.80

    Facility

    $71.88

    $14.45 lower than Merced for the office setting.

  • Puerto Rico

    Puerto Rico · 53866

    Office

    $146.54

    Facility

    $73.93

    $5.71 lower than Merced for the office setting.

  • Rhode Island

    Rhode Island · 53866

    Office

    $148.87

    Facility

    $74.68

    $3.38 lower than Merced for the office setting.

  • South Carolina

    South Carolina · 53866

    Office

    $137.75

    Facility

    $71.39

    $14.50 lower than Merced for the office setting.

  • South Dakota**

    South Dakota · 53866

    Office

    $141.41

    Facility

    $69.60

    $10.84 lower than Merced for the office setting.

  • Tennessee

    Tennessee · 53866

    Office

    $134.39

    Facility

    $69.11

    $17.86 lower than Merced for the office setting.

  • Austin

    Texas · 53866

    Office

    $150.29

    Facility

    $74.31

    $1.96 lower than Merced for the office setting.

  • Beaumont

    Texas · 53866

    Office

    $136.97

    Facility

    $71.62

    $15.28 lower than Merced for the office setting.

  • Brazoria

    Texas · 53866

    Office

    $143.80

    Facility

    $72.63

    $8.45 lower than Merced for the office setting.

  • Dallas

    Texas · 53866

    Office

    $144.79

    Facility

    $73.27

    $7.46 lower than Merced for the office setting.

  • Fort Worth

    Texas · 53866

    Office

    $143.97

    Facility

    $73.16

    $8.28 lower than Merced for the office setting.

  • Galveston

    Texas · 53866

    Office

    $144.28

    Facility

    $72.97

    $7.97 lower than Merced for the office setting.

  • Houston

    Texas · 53866

    Office

    $147.76

    Facility

    $76.45

    $4.49 lower than Merced for the office setting.

  • Rest Of Texas

    Texas · 53866

    Office

    $140.36

    Facility

    $72.21

    $11.89 lower than Merced for the office setting.

  • Utah

    Utah · 53866

    Office

    $139.51

    Facility

    $72.01

    $12.74 lower than Merced for the office setting.

  • Virginia

    Virginia · 53866

    Office

    $142.21

    Facility

    $71.62

    $10.04 lower than Merced for the office setting.

  • Virgin Islands

    United States Virgin Islands · 53866

    Office

    $146.54

    Facility

    $73.93

    $5.71 lower than Merced for the office setting.

  • Vermont

    Vermont · 53866

    Office

    $141.58

    Facility

    $70.49

    $10.67 lower than Merced for the office setting.

  • Rest Of Washington

    Washington · 53866

    Office

    $149.57

    Facility

    $73.95

    $2.68 lower than Merced for the office setting.

  • Seattle (King Cnty)

    Washington · 53866

    Office

    $167.57

    Facility

    $79.46

    $15.32 higher than Merced for the office setting.

  • Wisconsin

    Wisconsin · 53866

    Office

    $137.41

    Facility

    $68.61

    $14.84 lower than Merced for the office setting.

  • West Virginia

    West Virginia · 53866

    Office

    $136.42

    Facility

    $74.01

    $15.83 lower than Merced for the office setting.

  • Wyoming**

    Wyoming · 53866

    Office

    $143.98

    Facility

    $72.17

    $8.27 lower than Merced for the office setting.

See how rates vary across the country

53866 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$129.69

$172.75

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$172.751
AL$131.481
AR$129.691
AZ$141.891
CA$152.25–$188.2829
CO$150.651
CT$154.941
DC$165.171
DE$144.131
FL$144.81–$159.073
GA$137.00–$148.512
GU$155.451
HI$155.451
IA$134.051
ID$134.991
IL$141.27–$154.644
IN$135.711
KS$133.731
KY$134.971
LA$134.88–$141.112
MA$149.94–$164.592
MD$146.68–$165.173
ME$135.93–$142.472
MI$138.51–$146.792
MN$143.801
MO$132.88–$141.263
MS$131.301
MT$145.621
NC$137.231
ND$141.861
NE$134.661
NH$148.571
NJ$156.56–$163.682
NM$139.341
NV$144.661
NY$139.18–$171.385
OH$137.751
OK$134.461
OR$143.38–$154.892
PA$137.80–$151.462
PR$146.541
RI$148.871
SC$137.751
SD$141.411
TN$134.391
TX$136.97–$150.298
UT$139.511
VA$142.21–$165.172
VI$146.541
VT$141.581
WA$149.57–$167.572
WI$137.411
WV$136.421
WY$143.981

Explore 53866 on the national rate map →

Where does this rate apply?

Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in California →

Why are the office and facility amounts different?

For 53866 in Merced, the physician’s office rate is $152.25 and the facility-setting rate is $73.55: a difference of $78.70.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 53866 in Merced. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$167.48

$152.25 × 110% = $167.48

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 53866 in Merced.

PPRRVU2026_Oct_nonQPP.csv

6,233

Code
53866
Physician work
1.44
Practice expense
2.73
Malpractice
0.19

GPCI2026.csv

15

Locality
Merced
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 53866 in Merced
ComponentRVULocality factorAdjusted
Physician work1.44× 1.0171.4645
Practice expense2.73× 1.0962.9921
Malpractice0.19× 0.5360.1018
Total RVUs4.5584
Conversion factor× 33.4009

Office / nonfacility rate, Merced$152.25

Open 53866 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.441.017
Practice expense2.731.096
Malpractice0.190.536

(1.44 × 1.017 + 2.73 × 1.096 + 0.19 × 0.536) × $33.4009 = $152.25

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.441.017
Practice expense0.581.096
Malpractice0.190.536

(1.44 × 1.017 + 0.58 × 1.096 + 0.19 × 0.536) × $33.4009 = $73.55

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

53866 · Office / nonfacility

$152.25

Effective 2026-10-01

The base rate is $9.58 higher than on 2025-10-01, moving from $142.67 to $152.25 (6.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $142.67changed to$152.25

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.48 changed to 1.44
    • Practice expense RVU 2.57 changed to 2.73
    • Malpractice RVU 0.18 changed to 0.19
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $142.67

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$152.25$73.55RVU26D
2026-07-01$152.25$73.55RVU26C
2026-04-01$152.25$73.55RVU26B
2026-01-01$152.25$73.55RVU26A
2025-10-01$142.67$80.09RVU25D
2025-07-01$142.67$80.09RVU25C
2025-04-01$142.67$80.09RVU25B
2025-01-01$142.67$80.09RVU25A

53866 billing questions

How does this code differ from 53865?

53866 is for cystoscopic retrieval of the prostate remodeling device. 53865 describes its placement.

Can the removal be reported with another procedure on the same date?

When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction.

Should modifier 50 be used?

No. CMS identifies bilateral adjustment as inappropriate for this code.

Can an assistant surgeon or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.

What documentation supports the removal service?

Document the temporary remodeling device and its cystoscopic retrieval. The record should distinguish removal from the device's initial placement.

What care is included in the global period?

The 0-day global period includes same-day preoperative and 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 53866PPRRVU2026_Oct_nonQPP.csv, line 6,233 (RVU26D)
Geographic factors for MercedGPCI2026.csv, line 15 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet