No office rate
Choose 55876 for prostate markers or a dosimeter used to guide radiation localization. Choose 55875 for needle or catheter placement for interstitial radioactive-element treatment.
On this page
CMS RVU26D · Effective 2026-10-01
55876 Prostate markers Medicare reimbursement rates in Delaware
Needle placement of prostate fiducial markers or dosimeters to support image localization during planned radiation treatment. Compare 55876 office and facility rates across CMS payment localities in Delaware.
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 55876 in Delaware?
Delaware 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
$149.89
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
Facility setting
$90.16
1 of 1 localities have a supported rate.
Payment area: Delaware
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 55876: Prostate radiation marker placement
Needle placement of prostate fiducial markers or dosimeters to support image localization during planned radiation treatment.
This service places one or more small interstitial devices, such as fiducial markers or a dosimeter, in the prostate to help localize the gland during radiation treatment. A urologist or other qualified physician typically performs the needle-based procedure, often with imaging guidance, in an office or facility. The needle approach may vary; the purpose is radiation guidance rather than delivery of radioactive seeds or removal of prostate tissue.
Report one service for the marker-placement session; the code includes single or multiple devices. The record should identify the prostate as the target, the devices placed, and their radiation-guidance purpose. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this prostate service. Medicare does not pay an assistant at surgery; co-surgeon or team-surgery payment requires supporting documentation.
CMS billing rules for 55876
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery paid only with supporting documentation.
Where the value comes from
- Work RVU1.69 · 37%
- Practice expense (office) RVU2.65 · 58%
- Malpractice RVU0.19 · 4%
27.4K
Medicare services in 2024 · #1005 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.
55876 compared with similar codes
Office rates for Delaware, from the same CMS release.
$3,660.73
This code covers devices placed within the prostate for radiation guidance; 55874 covers biodegradable material placed around the prostate.
$5,625.72
55876 places radiation-guidance devices. 55873 describes prostate cryoablation, an ablative treatment rather than marker placement.
Compare 55876 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
Delaware →
Office / nonfacility
$149.89
Facility
$90.16
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 55876 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
6,394
- Code
- 55876
- Physician work
- 1.69
- Practice expense
- 2.65
- Malpractice
- 0.19
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.69 | × 1.005 | 1.6984 |
| Practice expense | 2.65 | × 0.988 | 2.6182 |
| Malpractice | 0.19 | × 0.899 | 0.1708 |
| Total RVUs | 4.4875 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Delaware$149.89
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.69 | 1.005 |
| Practice expense | 2.65 | 0.988 |
| Malpractice | 0.19 | 0.899 |
(1.69 × 1.005 + 2.65 × 0.988 + 0.19 × 0.899) × $33.4009 = $149.89
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.69 | 1.005 |
| Practice expense | 0.84 | 0.988 |
| Malpractice | 0.19 | 0.899 |
(1.69 × 1.005 + 0.84 × 0.988 + 0.19 × 0.899) × $33.4009 = $90.16
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.
55876 billing questions
Is this code for fiducial markers or brachytherapy seeds?
Use it for needle placement of prostate markers or a dosimeter to guide radiation localization. Brachytherapy needle or catheter placement is a different service, reported with 55875.
Does one code cover multiple markers?
Yes. The service includes placement of a single device or multiple devices during the session; the number of markers does not create additional units.
Can prostate spacer placement be reported at the same session?
Marker placement and biodegradable material placement around the prostate are distinct services and may occur during the same preparation encounter. Document each service performed.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this prostate service.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the other procedures are subject to a 50% reduction. Medicare does not pay an assistant at surgery; co-surgeon or team-surgery payment requires supporting documentation.
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.
6,39155873,,Cryoablate prostate,A,,13.26,155.45,,5.66,,1.69,170.40,20.61,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,39255874,,Tprnl plmt biodegrdabl matrl,A,,2.95,107.63,,0.99,,0.33,110.91,4.27,0,000,0.00,0.00,0.00,2,0,1,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
6,39355875,,Transperi needle place pros,A,,13.12,6.05,NA,6.05,,1.42,20.59,20.59,0,090,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,39455876,,Place rt device/marker pros,A,,1.69,2.65,,0.84,,0.19,4.53,2.72,0,000,0.00,0.00,0.00,2,0,1,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
6,39555877,,Abltj ire prst8 1+ tum perq,A,,13.50,4.99,NA,4.99,,1.61,20.10,20.10,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,39655880,,Abltj mal prst8 tiss hifu,A,,17.29,6.83,NA,6.83,,2.21,26.33,26.33,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,39755881,,Ablt trurl prst8 tis thrm us,A,,9.56,266.75,,2.06,,1.24,277.55,12.86,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503