Billing code 53866: Device removalMedicare rate & RVUs in Guam
Report cystoscopic removal of a temporary prostate remodeling device after treatment for urinary obstruction associated with benign prostatic enlargement.
Medicare pays $155.45 for 53866 in the office in Guam (Hawaii, Guam). Which amount applies depends on the service address.
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 53866 covers
A urologist uses cystoscopy to retrieve the temporary device previously placed to remodel the prostatic urethra through ischemic effects. The treatment is used for urinary symptoms associated with benign prostatic enlargement; this code describes the removal service, not initial device placement. Removal is generally performed in an outpatient setting after the device has served its intended remodeling purpose.
Report the removal code for the cystoscopic retrieval, supported by documentation identifying the device and recording its removal. Code 53865 describes placement of the device. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed 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. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing are 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.
53866 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $155.45 | $73.80 |
How the 53866 rate is calculated
Each of 53866’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 · 53866
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.44Practice expense 2.73Malpractice 0.19
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 53866
The CMS indicators that decide how 53866 is paid alongside other services.
CMS payment indicators · 53866
Device removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
53866 without 51 · national office
$145.63
Device removal
53866-51 · Second procedure: 50%
$72.82
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%).
53866 compared with similar codes
Compare codes
53866 vs 53865 vs 53850 vs 53854: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 53865Prostate remodeling
- Use 53865 for cystoscopic placement of the temporary remodeling device; use 53866 for its removal.
- 53850Prostate treatment
- This code describes removal of a remodeling device. Code 53850 represents microwave thermotherapy of prostate tissue.
- 53854Prostate ablation
- This code covers cystoscopic device retrieval; 53854 describes prostate tissue treatment using radiofrequency-generated water vapor.
53866 billing questions
How does this code differ from 53865?
53866 is for cystoscopic retrieval of the prostate remodeling device. 53865 describes its placement.
Can the removal be reported with another procedure on the same date?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction.
Should modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
What documentation supports the removal service?
Document the temporary remodeling device and its cystoscopic retrieval. The record should distinguish removal from the device's initial placement.
What care is included in the global period?
The 0-day global period includes same-day preoperative and 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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