CPT code 55831: Prostatectomy2026 Medicare rate & RVUs in Alabama
Open retropubic subtotal prostatectomy removes obstructing prostate tissue for selected patients with benign enlargement when an open simple-prostatectomy approach is performed.
CMS doesn’t publish an office rate for 55831 in Alabama.
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 9 sections
What 55831 covers
This open operation removes the obstructing portion of an enlarged prostate through a retropubic approach, leaving the outer prostate capsule rather than removing the gland as a cancer operation. Urologists typically perform it in a hospital operating room for patients with benign prostatic enlargement who need surgical treatment. The operative approach distinguishes this service from subtotal procedures using a perineal or suprapubic route and from radical prostatectomy.
Report 55831 when the operative record supports subtotal removal by the retropubic route. Documentation should identify the indication, surgical approach, and extent of tissue removed. The code includes related services named in its descriptor, such as control of postoperative bleeding, vasectomy, meatotomy, urethral calibration or dilation, and internal urethrotomy when performed as part of the operation. It has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is 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.
55831 in Alabama
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Unavailable | $720.90 |
How the 55831 rate is calculated
Each of 55831’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 · 55831
RVUs × geographic indexes × conversion factor
Work15.21
15.21 RVUs× 1.000 GPCI
Practice expense5.99
5.99 RVUs× 1.000 GPCI
Malpractice2.00
2.00 RVUs× 1.000 GPCI
Adjusted RVUs
23.2000
Conversion factor
$33.4009
Medicare rate
$774.90
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 55831
55831 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 55831
Prostatectomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 55831
Prostatectomy
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
55831 without 51 · national facility
$774.90
Prostatectomy
55831-51 · Second procedure: 50%
$387.45
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%).
55831 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 55821Prostatectomy
- Both are subtotal procedures; 55831 uses a retropubic route, while 55821 uses a suprapubic route. Follow the documented operative approach.
- 55801Prostatectomy
- 55801 is the perineal subtotal procedure. Use 55831 for subtotal removal performed through a retropubic approach.
- 55840Radical prostatectomy
- 55840 describes radical retropubic prostatectomy, not subtotal removal. Select based on whether the operative report documents radical gland removal or a simple/subtotal procedure.
- 55867Prostatectomy
- Both involve simple/subtotal prostate removal, but 55867 is laparoscopic and 55831 is the open retropubic procedure.
55831 billing questions
How does 55831 differ from 55821?
Both describe subtotal prostate removal, but 55831 is the retropubic approach and 55821 is the suprapubic approach. The operative report must support the route performed.
When would 55801 be reported instead?
55801 describes subtotal prostate removal through a perineal approach. Choose 55831 when the surgeon uses the retropubic route.
Is 55831 a radical prostatectomy?
No. It represents subtotal removal, typically for benign enlargement, rather than radical removal of the prostate for cancer. Radical retropubic surgery is represented by codes such as 55840.
Can associated procedures be billed separately?
Services identified as included in the descriptor—such as control of postoperative bleeding, vasectomy, meatotomy, urethral calibration or dilation, and internal urethrotomy—are part of the operation when performed as related services.
What are the assistant and co-surgeon rules?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Does modifier 50 apply, and what is the global period?
Modifier 50 is inappropriate for this procedure. The 90-day global period includes the day-before preoperative visit and 90 days of related 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 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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