No office rate
Both describe laparoscopic radical prostatectomy, but 55865 includes bilateral pelvic lymphadenectomy; 55866 is used when that dissection is not performed.
On this page
CMS RVU26D · Effective 2026-10-01
55865 Prostatectomy Medicare reimbursement rates in Hawaii
Reports laparoscopic radical removal of the prostate with bilateral pelvic lymph node dissection, including nerve-sparing work when performed. Compare 55865 office and facility rates across CMS payment localities in Hawaii.
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 55865 in Hawaii?
Hawaii 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
No supported rate
Facility setting
$1187.58
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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.
Urologic surgery
About 55865: Laparoscopic radical prostatectomy with bilateral lymphadenectomy
Reports laparoscopic radical removal of the prostate with bilateral pelvic lymph node dissection, including nerve-sparing work when performed.
A urologist performs this laparoscopic operation to remove the prostate and dissect pelvic lymph nodes on both sides, including the external iliac, hypogastric, and obturator nodal groups. Nerve-sparing may be performed when clinically feasible. It is typically used for prostate cancer and performed in a hospital operating room; robotic assistance may be used as part of the laparoscopic approach.
Choose this code when the operative report supports both radical prostate removal and bilateral pelvic lymphadenectomy. Document the approach, extent of prostate removal, nodal regions dissected, and any nerve-sparing work. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. The service is priced as bilateral, so modifier 50 does not increase payment. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 55865
- 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
- The code is already priced as bilateral; modifier 50 does not increase payment.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU23.96 · 67%
- Practice expense (office) RVU8.64 · 24%
- Malpractice RVU3.06 · 9%
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.
55865 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
This is the open retropubic approach with bilateral pelvic lymphadenectomy. Use 55865 for the laparoscopic approach.
No office rate
This is an open radical prostatectomy with limited lymph node biopsy, not the laparoscopic procedure with bilateral pelvic lymphadenectomy.
Compare 55865 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$1187.58
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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 55865 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
6,385
- Code
- 55865
- Physician work
- 23.96
- Practice expense
- 8.64
- Malpractice
- 3.06
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 23.96 | × 1.000 | 23.9600 |
| Practice expense | 8.64 | × 1.137 | 9.8237 |
| Malpractice | 3.06 | × 0.579 | 1.7717 |
| Total RVUs | 35.5554 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$1187.58
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 23.96 | 1 |
| Practice expense | 8.64 | 1.137 |
| Malpractice | 3.06 | 0.579 |
(23.96 × 1 + 8.64 × 1.137 + 3.06 × 0.579) × $33.4009 = $1187.58
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.
55865 billing questions
How does this differ from 55866?
55865 includes bilateral pelvic lymphadenectomy with the laparoscopic radical prostatectomy. Use 55866 when the laparoscopic radical prostatectomy is performed without that bilateral node dissection.
Should modifier 50 be appended for the bilateral node dissection?
The code is already priced as bilateral, and modifier 50 does not increase payment.
Is the pelvic lymphadenectomy included?
Yes. The code covers the bilateral dissection of the specified pelvic nodal groups as part of the laparoscopic radical prostatectomy.
What documentation supports reporting 55865?
The operative report should establish the laparoscopic approach, radical prostate removal, and bilateral dissection of pelvic nodes, identifying the nodal regions addressed.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.
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.
6,38255845,,Extensive prostate surgery,A,,24.55,8.49,NA,8.49,,3.17,36.21,36.21,0,090,0.10,0.80,0.10,2,2,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,38355860,,Surgical exposure prostate,A,,15.44,6.11,NA,6.11,,1.98,23.53,23.53,0,090,0.10,0.80,0.10,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,38455862,,Extensive prostate surgery,A,,19.54,7.33,NA,7.33,,2.51,29.38,29.38,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,38555865,,Extensive prostate surgery,A,,23.96,8.64,NA,8.64,,3.06,35.66,35.66,0,090,0.10,0.80,0.10,2,2,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,38655866,,Laps surg prst8ect rpbic rad,A,,21.90,7.66,NA,7.66,,2.83,32.39,32.39,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,38755867,,Laps surg prst8ect smpl stot,A,,19.04,6.82,NA,6.82,,2.46,28.32,28.32,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,38855868,,Lap srg prst8ct lymph nod bx,A,,22.46,7.79,NA,7.79,,2.91,33.16,33.16,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014