Billing code 55840: Radical prostatectomyMedicare rate & RVUs in Delaware
Reports open retropubic removal of the prostate for radical treatment, with or without nerve sparing, when the separately defined lymphadenectomy variants are not performed.
CMS doesn’t publish an office rate for 55840 in Delaware.
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 55840 covers
A urologist typically performs this open operation through a lower abdominal incision to remove the prostate as radical treatment, commonly for prostate cancer. Nerve-sparing dissection may be performed when clinically appropriate. This code identifies the retropubic approach without the bilateral pelvic lymphadenectomy variants in the same code family; the operative report should support the approach, extent of prostate removal, and whether nerve sparing was performed.
Report the code when the documented operation matches the open retropubic radical procedure, rather than a perineal or laparoscopic approach or a lymphadenectomy variant. CMS assigns a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%. An assistant at surgery may be paid; 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.
55840 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $1,036.31 |
How the 55840 rate is calculated
Each of 55840’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 · 55840
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 20.83Practice expense 7.74Malpractice 2.72
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 55840
55840 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 55840
Radical 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 · 55840
Radical 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
55840 without 51 · national facility
$1,045.11
Radical prostatectomy
55840-51 · Second procedure: 50%
$522.56
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%).
55840 compared with similar codes
Compare codes
55840 vs 55810 vs 55842 vs 55866: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 55810Radical prostatectomy
- This code is for the open retropubic approach. Choose 55810 when the radical prostatectomy is performed through the perineal approach.
- 55842Radical prostatectomy
- Both are retropubic radical prostatectomy codes; 55842 identifies the variant that includes bilateral pelvic lymphadenectomy.
- 55866Prostatectomy
- 55866 describes laparoscopic radical prostatectomy. Use 55840 for the open retropubic operation.
55840 billing questions
How is this code distinguished from 55810?
Both describe radical prostatectomy, but 55840 is the open retropubic approach and 55810 is the perineal approach. Use the approach documented in the operative report.
Which code applies when bilateral pelvic lymphadenectomy is performed?
Use the applicable lymphadenectomy variant in the 55840 family, such as 55842 or 55845, rather than reporting 55840 for that operative configuration.
Does nerve sparing change the code selection?
No. This code includes the retropubic radical procedure whether or not nerve-sparing dissection is performed.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
CMS may pay for an assistant at surgery. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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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