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CMS RVU26D · Effective 2026-10-01

55715 in Merced

Office / nonfacility

$83.57

Base rate per service

Facility setting

$46.23

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 55715: Additional MRI-guided prostate lesion biopsy

Reports sampling of each additional prostate lesion targeted with MRI-US fusion or CT/MR guidance during a guided prostate biopsy.

This add-on represents sampling an additional distinct prostate lesion after the primary lesion in a biopsy performed with MRI-US fusion or CT/MR guidance. A urologist typically uses MRI findings to identify targets and obtain tissue cores from them in an outpatient procedure room or hospital setting. The additional lesion may be sampled during the same session as systematic cores, but those cores alone do not establish an additional targeted lesion.

Report this code with the applicable primary procedure for the guided biopsy, such as the first-lesion codes 55711–55714. The record should identify the additional target and support that it was sampled; count distinct lesions, not the number of cores taken from one lesion. This is an add-on code, not a stand-alone service, and Medicare pays it within the primary procedure’s global period.

CMS billing rules for 55715

Global period
Add-on code: billed only together with a primary procedure and paid within that procedure's global period.

Where the value comes from

  • Work RVU1.05 · 43%
  • Practice expense (office) RVU1.24 · 51%
  • Malpractice RVU0.14 · 6%

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.

55715 compared with similar codes

Office rates for Merced, from the same CMS release.

55711

Prostate biopsy

Transrectal fusion, first lesion

$389.25

55711 represents the first lesion sampled with transrectal MRI-US guidance. Use 55715 for each additional distinct lesion sampled in the applicable guided-biopsy session.

55712

Prostate biopsy

Transperineal fusion, first lesion

$649.31

55712 represents the first lesion sampled with transperineal MRI-US guidance. This code is for additional distinct lesions, not the initial target.

55713

Prostate biopsy

In-bore CT or MRI guidance

$817.67

55713 represents the first lesion in an in-bore CT/MRI-guided biopsy. This code accounts for additional distinct lesion sampling.

55706

Prostate biopsy

Saturation sampling

No office rate

55706 describes transperineal template-guided saturation sampling. It is not the additional-lesion code for an MRI-US fusion or CT/MR-guided biopsy.

The same code, a different location

How does Merced compare?

In Bakersfield, the office rate for 55715 is $83.98—$0.41 higher than the $83.57 rate in Merced. Both use the same code, release and participation basis.

55715 across payment areas

Same release and payment basis · bars start at $0

  1. Merced · This locality

    $83.57

  2. Bakersfield

    $83.98

    $0.41 higher than Merced

  3. Chico

    $83.57

    The same base rate than Merced

  4. El Centro

    $83.59

    $0.02 higher than Merced

  5. Fresno

    $83.57

    The same base rate than Merced

  6. Hanford-Corcoran

    $83.57

    The same base rate than Merced

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

    $88.61

    $5.04 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, 55715 ranges from $73.06 in Arkansas to $101.16 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 · 55715

    Office

    $83.57

    Facility

    $46.23

    The same base rate than Merced for the office setting.

  • Modesto

    California · 55715

    Office

    $83.57

    Facility

    $46.23

    The same base rate than Merced for the office setting.

  • Napa

    California · 55715

    Office

    $94.24

    Facility

    $49.34

    $10.67 higher than Merced for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 55715

    Office

    $87.92

    Facility

    $47.65

    $4.35 higher than Merced for the office setting.

  • Redding

    California · 55715

    Office

    $83.57

    Facility

    $46.23

    The same base rate than Merced for the office setting.

  • Rest Of California

    California · 55715

    Office

    $83.57

    Facility

    $46.23

    The same base rate than Merced for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 55715

    Office

    $85.08

    Facility

    $47.74

    $1.51 higher than Merced for the office setting.

  • Sacramento-Roseville-Folsom

    California · 55715

    Office

    $87.01

    Facility

    $47.39

    $3.44 higher than Merced for the office setting.

  • Salinas

    California · 55715

    Office

    $86.67

    Facility

    $47.18

    $3.10 higher than Merced for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 55715

    Office

    $88.19

    Facility

    $47.45

    $4.62 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 55715

    Office

    $98.95

    Facility

    $50.91

    $15.38 higher than Merced for the office setting.

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

    California · 55715

    Office

    $98.79

    Facility

    $50.75

    $15.22 higher than Merced for the office setting.

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

    California · 55715

    Office

    $101.16

    Facility

    $52.03

    $17.59 higher than Merced for the office setting.

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

    California · 55715

    Office

    $100.51

    Facility

    $51.38

    $16.94 higher than Merced for the office setting.

  • San Luis Obispo-Paso Robles

    California · 55715

    Office

    $85.35

    Facility

    $46.54

    $1.78 higher than Merced for the office setting.

  • Santa Cruz-Watsonville

    California · 55715

    Office

    $88.64

    Facility

    $47.24

    $5.07 higher than Merced for the office setting.

  • Santa Maria-Santa Barbara

    California · 55715

    Office

    $86.85

    Facility

    $47.13

    $3.28 higher than Merced for the office setting.

  • Santa Rosa-Petaluma

    California · 55715

    Office

    $89.49

    Facility

    $47.65

    $5.92 higher than Merced for the office setting.

  • Stockton

    California · 55715

    Office

    $83.57

    Facility

    $46.23

    The same base rate than Merced for the office setting.

  • Vallejo

    California · 55715

    Office

    $94.01

    Facility

    $49.11

    $10.44 higher than Merced for the office setting.

  • Visalia

    California · 55715

    Office

    $83.57

    Facility

    $46.23

    The same base rate than Merced for the office setting.

  • Yuba City

    California · 55715

    Office

    $83.57

    Facility

    $46.23

    The same base rate than Merced for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 55715

    Office

    $90.96

    Facility

    $50.83

    $7.39 higher than Merced for the office setting.

  • Miami

    Florida · 55715

    Office

    $90.01

    Facility

    $54.55

    $6.44 higher than Merced for the office setting.

  • Chicago

    Illinois · 55715

    Office

    $87.67

    Facility

    $53.43

    $4.10 higher than Merced for the office setting.

  • Manhattan

    New York · 55715

    Office

    $92.86

    Facility

    $53.27

    $9.29 higher than Merced for the office setting.

  • Alaska*

    Alaska · 55715

    Office

    $99.29

    Facility

    $63.01

    $15.72 higher than Merced for the office setting.

  • Alabama

    Alabama · 55715

    Office

    $73.96

    Facility

    $44.15

    $9.61 lower than Merced for the office setting.

  • Arkansas

    Arkansas · 55715

    Office

    $73.06

    Facility

    $43.79

    $10.51 lower than Merced for the office setting.

  • Arizona

    Arizona · 55715

    Office

    $79.21

    Facility

    $46.19

    $4.36 lower than Merced for the office setting.

  • Colorado

    Colorado · 55715

    Office

    $83.21

    Facility

    $46.96

    $0.36 lower than Merced for the office setting.

  • Connecticut

    Connecticut · 55715

    Office

    $86.04

    Facility

    $49.34

    $2.47 higher than Merced for the office setting.

  • Delaware

    Delaware · 55715

    Office

    $80.37

    Facility

    $46.71

    $3.20 lower than Merced for the office setting.

  • Fort Lauderdale

    Florida · 55715

    Office

    $85.48

    Facility

    $50.97

    $1.91 higher than Merced for the office setting.

  • Rest Of Florida

    Florida · 55715

    Office

    $81.69

    Facility

    $49.12

    $1.88 lower than Merced for the office setting.

  • Atlanta

    Georgia · 55715

    Office

    $82.87

    Facility

    $48.26

    $0.70 lower than Merced for the office setting.

  • Rest Of Georgia

    Georgia · 55715

    Office

    $77.59

    Facility

    $47.20

    $5.98 lower than Merced for the office setting.

  • Hawaii, Guam

    Hawaii · 55715

    Office

    $84.87

    Facility

    $46.13

    $1.30 higher than Merced for the office setting.

  • Iowa

    Iowa · 55715

    Office

    $74.82

    Facility

    $43.65

    $8.75 lower than Merced for the office setting.

  • Idaho

    Idaho · 55715

    Office

    $75.39

    Facility

    $44.04

    $8.18 lower than Merced for the office setting.

  • East St. Louis

    Illinois · 55715

    Office

    $82.59

    Facility

    $51.25

    $0.98 lower than Merced for the office setting.

  • Rest Of Illinois

    Illinois · 55715

    Office

    $80.19

    Facility

    $49.09

    $3.38 lower than Merced for the office setting.

  • Suburban Chicago

    Illinois · 55715

    Office

    $86.14

    Facility

    $51.15

    $2.57 higher than Merced for the office setting.

  • Indiana

    Indiana · 55715

    Office

    $75.74

    Facility

    $44.16

    $7.83 lower than Merced for the office setting.

  • Kansas

    Kansas · 55715

    Office

    $74.87

    Facility

    $44.07

    $8.70 lower than Merced for the office setting.

  • Kentucky

    Kentucky · 55715

    Office

    $76.17

    Facility

    $45.88

    $7.40 lower than Merced for the office setting.

  • New Orleans

    Louisiana · 55715

    Office

    $79.36

    Facility

    $47.30

    $4.21 lower than Merced for the office setting.

  • Rest Of Louisiana

    Louisiana · 55715

    Office

    $76.20

    Facility

    $46.05

    $7.37 lower than Merced for the office setting.

  • Metropolitan Boston

    Massachusetts · 55715

    Office

    $90.12

    Facility

    $49.44

    $6.55 higher than Merced for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 55715

    Office

    $82.97

    Facility

    $47.10

    $0.60 lower than Merced for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 55715

    Office

    $85.86

    Facility

    $49.30

    $2.29 higher than Merced for the office setting.

  • Rest Of Maryland

    Maryland · 55715

    Office

    $81.63

    Facility

    $47.15

    $1.94 lower than Merced for the office setting.

  • Rest Of Maine

    Maine · 55715

    Office

    $76.08

    Facility

    $44.74

    $7.49 lower than Merced for the office setting.

  • Southern Maine

    Maine · 55715

    Office

    $79.07

    Facility

    $45.30

    $4.50 lower than Merced for the office setting.

  • Detroit

    Michigan · 55715

    Office

    $82.92

    Facility

    $50.05

    $0.65 lower than Merced for the office setting.

  • Rest Of Michigan

    Michigan · 55715

    Office

    $78.16

    Facility

    $47.06

    $5.41 lower than Merced for the office setting.

  • Minnesota

    Minnesota · 55715

    Office

    $79.07

    Facility

    $44.02

    $4.50 lower than Merced for the office setting.

  • Metropolitan Kansas City

    Missouri · 55715

    Office

    $78.53

    Facility

    $46.54

    $5.04 lower than Merced for the office setting.

  • Metropolitan St. Louis

    Missouri · 55715

    Office

    $79.19

    Facility

    $46.75

    $4.38 lower than Merced for the office setting.

  • Rest Of Missouri

    Missouri · 55715

    Office

    $75.33

    Facility

    $45.96

    $8.24 lower than Merced for the office setting.

  • Mississippi

    Mississippi · 55715

    Office

    $74.19

    Facility

    $44.85

    $9.38 lower than Merced for the office setting.

  • Montana**

    Montana · 55715

    Office

    $81.15

    Facility

    $47.09

    $2.42 lower than Merced for the office setting.

  • North Carolina

    North Carolina · 55715

    Office

    $76.70

    Facility

    $44.91

    $6.87 lower than Merced for the office setting.

  • North Dakota**

    North Dakota · 55715

    Office

    $78.39

    Facility

    $44.32

    $5.18 lower than Merced for the office setting.

  • Nebraska

    Nebraska · 55715

    Office

    $75.07

    Facility

    $43.62

    $8.50 lower than Merced for the office setting.

  • New Hampshire

    New Hampshire · 55715

    Office

    $82.28

    Facility

    $46.81

    $1.29 lower than Merced for the office setting.

  • Northern Nj

    New Jersey · 55715

    Office

    $90.32

    Facility

    $50.80

    $6.75 higher than Merced for the office setting.

  • Rest Of New Jersey

    New Jersey · 55715

    Office

    $86.83

    Facility

    $49.63

    $3.26 higher than Merced for the office setting.

  • New Mexico

    New Mexico · 55715

    Office

    $78.67

    Facility

    $47.43

    $4.90 lower than Merced for the office setting.

  • Nevada**

    Nevada · 55715

    Office

    $80.42

    Facility

    $46.32

    $3.15 lower than Merced for the office setting.

  • Nyc Suburbs/Long Island

    New York · 55715

    Office

    $95.24

    Facility

    $54.74

    $11.67 higher than Merced for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 55715

    Office

    $87.66

    Facility

    $50.35

    $4.09 higher than Merced for the office setting.

  • Queens

    New York · 55715

    Office

    $93.01

    Facility

    $52.74

    $9.44 higher than Merced for the office setting.

  • Rest Of New York

    New York · 55715

    Office

    $77.70

    Facility

    $45.34

    $5.87 lower than Merced for the office setting.

  • Ohio

    Ohio · 55715

    Office

    $77.60

    Facility

    $46.49

    $5.97 lower than Merced for the office setting.

  • Oklahoma

    Oklahoma · 55715

    Office

    $75.69

    Facility

    $45.27

    $7.88 lower than Merced for the office setting.

  • Portland

    Oregon · 55715

    Office

    $85.13

    Facility

    $47.27

    $1.56 higher than Merced for the office setting.

  • Rest Of Oregon

    Oregon · 55715

    Office

    $79.61

    Facility

    $45.68

    $3.96 lower than Merced for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 55715

    Office

    $84.40

    Facility

    $48.93

    $0.83 higher than Merced for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 55715

    Office

    $77.51

    Facility

    $46.24

    $6.06 lower than Merced for the office setting.

  • Puerto Rico

    Puerto Rico · 55715

    Office

    $81.55

    Facility

    $47.11

    $2.02 lower than Merced for the office setting.

  • Rhode Island

    Rhode Island · 55715

    Office

    $82.69

    Facility

    $47.50

    $0.88 lower than Merced for the office setting.

  • South Carolina

    South Carolina · 55715

    Office

    $77.32

    Facility

    $45.84

    $6.25 lower than Merced for the office setting.

  • South Dakota**

    South Dakota · 55715

    Office

    $78.06

    Facility

    $43.99

    $5.51 lower than Merced for the office setting.

  • Tennessee

    Tennessee · 55715

    Office

    $75.23

    Facility

    $44.26

    $8.34 lower than Merced for the office setting.

  • Austin

    Texas · 55715

    Office

    $83.10

    Facility

    $47.06

    $0.47 lower than Merced for the office setting.

  • Beaumont

    Texas · 55715

    Office

    $77.10

    Facility

    $46.10

    $6.47 lower than Merced for the office setting.

  • Brazoria

    Texas · 55715

    Office

    $80.04

    Facility

    $46.28

    $3.53 lower than Merced for the office setting.

  • Dallas

    Texas · 55715

    Office

    $80.65

    Facility

    $46.72

    $2.92 lower than Merced for the office setting.

  • Fort Worth

    Texas · 55715

    Office

    $80.30

    Facility

    $46.70

    $3.27 lower than Merced for the office setting.

  • Galveston

    Texas · 55715

    Office

    $80.35

    Facility

    $46.52

    $3.22 lower than Merced for the office setting.

  • Houston

    Texas · 55715

    Office

    $82.91

    Facility

    $49.08

    $0.66 lower than Merced for the office setting.

  • Rest Of Texas

    Texas · 55715

    Office

    $78.60

    Facility

    $46.27

    $4.97 lower than Merced for the office setting.

  • Utah

    Utah · 55715

    Office

    $78.20

    Facility

    $46.18

    $5.37 lower than Merced for the office setting.

  • Virginia

    Virginia · 55715

    Office

    $79.09

    Facility

    $45.60

    $4.48 lower than Merced for the office setting.

  • Virgin Islands

    United States Virgin Islands · 55715

    Office

    $81.55

    Facility

    $47.11

    $2.02 lower than Merced for the office setting.

  • Vermont

    Vermont · 55715

    Office

    $78.44

    Facility

    $44.71

    $5.13 lower than Merced for the office setting.

  • Rest Of Washington

    Washington · 55715

    Office

    $82.70

    Facility

    $46.82

    $0.87 lower than Merced for the office setting.

  • Seattle (King Cnty)

    Washington · 55715

    Office

    $91.46

    Facility

    $49.66

    $7.89 higher than Merced for the office setting.

  • Wisconsin

    Wisconsin · 55715

    Office

    $76.19

    Facility

    $43.55

    $7.38 lower than Merced for the office setting.

  • West Virginia

    West Virginia · 55715

    Office

    $77.75

    Facility

    $48.15

    $5.82 lower than Merced for the office setting.

  • Wyoming**

    Wyoming · 55715

    Office

    $79.95

    Facility

    $45.88

    $3.62 lower than Merced for the office setting.

See how rates vary across the country

55715 · 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.

$73.06

$99.29

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$99.291
AL$73.961
AR$73.061
AZ$79.211
CA$83.57–$101.1629
CO$83.211
CT$86.041
DC$90.961
DE$80.371
FL$81.69–$90.013
GA$77.59–$82.872
GU$84.871
HI$84.871
IA$74.821
ID$75.391
IL$80.19–$87.674
IN$75.741
KS$74.871
KY$76.171
LA$76.20–$79.362
MA$82.97–$90.122
MD$81.63–$90.963
ME$76.08–$79.072
MI$78.16–$82.922
MN$79.071
MO$75.33–$79.193
MS$74.191
MT$81.151
NC$76.701
ND$78.391
NE$75.071
NH$82.281
NJ$86.83–$90.322
NM$78.671
NV$80.421
NY$77.70–$95.245
OH$77.601
OK$75.691
OR$79.61–$85.132
PA$77.51–$84.402
PR$81.551
RI$82.691
SC$77.321
SD$78.061
TN$75.231
TX$77.10–$83.108
UT$78.201
VA$79.09–$90.962
VI$81.551
VT$78.441
WA$82.70–$91.462
WI$76.191
WV$77.751
WY$79.951

Explore 55715 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 55715 in Merced, the physician’s office rate is $83.57 and the facility-setting rate is $46.23: a difference of $37.34.

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 55715 in Merced. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$91.93

$83.57 × 110% = $91.93

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 55715 in Merced.

PPRRVU2026_Oct_nonQPP.csv

6,371

Code
55715
Physician work
1.05
Practice expense
1.24
Malpractice
0.14

GPCI2026.csv

15

Locality
Merced
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 55715 in Merced
ComponentRVULocality factorAdjusted
Physician work1.05× 1.0171.0678
Practice expense1.24× 1.0961.3590
Malpractice0.14× 0.5360.0750
Total RVUs2.5019
Conversion factor× 33.4009

Office / nonfacility rate, Merced$83.57

Open 55715 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.051.017
Practice expense1.241.096
Malpractice0.140.536

(1.05 × 1.017 + 1.24 × 1.096 + 0.14 × 0.536) × $33.4009 = $83.57

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.051.017
Practice expense0.221.096
Malpractice0.140.536

(1.05 × 1.017 + 0.22 × 1.096 + 0.14 × 0.536) × $33.4009 = $46.23

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

55715 · Office / nonfacility

$83.57

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

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

    No ratechanged to$83.57

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: No rate

    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$83.57$46.23RVU26D
2026-07-01$83.57$46.23RVU26C
2026-04-01$83.57$46.23RVU26B
2026-01-01$83.57$46.23RVU26A
2025-10-01Not in this releaseNot in this releaseRVU25D
2025-07-01Not in this releaseNot in this releaseRVU25C
2025-04-01Not in this releaseNot in this releaseRVU25B
2025-01-01Not in this releaseNot in this releaseRVU25A

55715 billing questions

When is this code reported instead of a first-lesion code?

Use it for an additional distinct lesion sampled during an MRI-US fusion or CT/MR-guided prostate biopsy. The applicable primary code represents the first lesion.

Which primary procedure codes can it accompany?

Pair it with the applicable primary guided-biopsy code, including the first-lesion codes 55711–55714. It cannot be reported by itself.

Are additional cores from one target separately counted?

No. The unit is based on an additional distinct lesion sampled, not the number of cores obtained from that lesion.

What documentation supports an additional lesion?

Document the additional target, its identification through the guided-biopsy process, and that tissue was sampled from it.

How does Medicare treat payment for this add-on?

Medicare pays it only with a primary procedure and within that procedure’s global period.

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 55715PPRRVU2026_Oct_nonQPP.csv, line 6,371 (RVU26D)
Geographic factors for MercedGPCI2026.csv, line 15 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet