$1,238.32
Both describe transurethral radiofrequency treatment of prostate tissue, but 53852 specifies radiofrequency thermotherapy. Base code selection on the documented procedure technique.
On this page
CMS RVU26D · Effective 2026-10-01
53860 Prostate treatment Medicare reimbursement rates in Alabama
Reports transurethral radiofrequency treatment of prostate tissue, typically for urinary symptoms associated with benign prostatic enlargement. Compare 53860 office and facility rates across CMS payment localities in Alabama.
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.
What does Medicare pay for 53860 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$2103.77
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
Facility setting
$187.73
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Urology procedure
About 53860: Transurethral prostate radiofrequency treatment
Reports transurethral radiofrequency treatment of prostate tissue, typically for urinary symptoms associated with benign prostatic enlargement.
A urologist delivers radiofrequency energy to prostate tissue through a transurethral instrument to treat enlargement-related urinary obstruction. The treatment is performed in an office or other outpatient setting; the instrument and treatment method distinguish it from microwave thermotherapy, water-vapor treatment, and tissue resection. The clinical record should support the prostate condition being treated and describe the procedure and radiofrequency technique used.
Report the code for the transurethral radiofrequency treatment itself, with documentation identifying the treated tissue and method. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures 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. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 53860
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.87 · 5%
- Practice expense (office) RVU67.25 · 94%
- Malpractice RVU0.48 · 1%
22
Medicare services in 2024 · #5873 by national volume
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.
53860 compared with similar codes
Office rates for Alabama, from the same CMS release.
$1,263.95
This code identifies microwave thermotherapy of prostate tissue, not transurethral radiofrequency treatment.
$2,987.49
This code identifies treatment using radiofrequency-generated water vapor, a different method from the radiofrequency treatment reported with 53860.
Compare 53860 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
$2103.77
Facility
$187.73
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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 53860 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
6,231
- Code
- 53860
- Physician work
- 3.87
- Practice expense
- 67.25
- Malpractice
- 0.48
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.87 | × 1.000 | 3.8700 |
| Practice expense | 67.25 | × 0.875 | 58.8438 |
| Malpractice | 0.48 | × 0.566 | 0.2717 |
| Total RVUs | 62.9854 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alabama$2103.77
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.87 | 1 |
| Practice expense | 67.25 | 0.875 |
| Malpractice | 0.48 | 0.566 |
(3.87 × 1 + 67.25 × 0.875 + 0.48 × 0.566) × $33.4009 = $2103.77
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.87 | 1 |
| Practice expense | 1.69 | 0.875 |
| Malpractice | 0.48 | 0.566 |
(3.87 × 1 + 1.69 × 0.875 + 0.48 × 0.566) × $33.4009 = $187.73
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.
53860 billing questions
How does this differ from 53852?
Both involve transurethral radiofrequency treatment of prostate tissue. Use the code that matches the specific procedure and technique documented; 53852 identifies radiofrequency thermotherapy.
Can this be reported with microwave or water-vapor treatment?
Those are distinct treatment methods, represented by 53850 for microwave thermotherapy and 53854 for radiofrequency-generated water-vapor thermotherapy. Select the code for the method actually performed.
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 be used?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
When is an assistant-at-surgery payment allowed?
Only when medical necessity for the assistant is documented. Co-surgeons and team surgery are not permitted for this code.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in the same session are subject to the standard multiple-procedure reduction.
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.
6,22853852,,Prostatic rf thermotx,A,,5.78,35.28,,4.06,,0.75,41.81,10.59,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,22953854,,Trurl dstrj prst8 tiss rf wv,A,,5.78,95.13,,4.07,,0.75,101.66,10.60,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,23053855,,Insert prost urethral stent,A,,1.60,17.77,,0.34,,0.21,19.58,2.15,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,23153860,,Transurethral rf treatment,A,,3.87,67.25,,1.69,,0.48,71.60,6.04,0,090,0.08,0.83,0.09,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,23253865,,Cysto insj dev ischmc rmdlg,A,,3.02,89.00,,0.95,,0.39,92.41,4.36,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,23353866,,Cathj rmvl dev ischmc rmdlg,A,,1.44,2.73,,0.58,,0.19,4.36,2.21,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,23453899,,Unlisted px urinary system,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515