No office rate
Both codes describe prostate abscess drainage; select 55725 for the transurethral route and 55720 for a non-transurethral route.
On this page
CMS RVU26D · Effective 2026-10-01
55720 Abscess drainage Medicare reimbursement rates in Idaho
Surgical drainage of a prostate abscess by a non-transurethral route, reported when the operative service opens and evacuates the infected collection. Compare 55720 office and facility rates across CMS payment localities in Idaho.
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 55720 in Idaho?
Idaho 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
$387.48
1 of 1 localities have a supported rate.
Payment area: Idaho
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 surgery
About 55720: Non-transurethral prostate abscess drainage
Surgical drainage of a prostate abscess by a non-transurethral route, reported when the operative service opens and evacuates the infected collection.
A urologist uses this service to drain an abscess within the prostate through a non-transurethral route. The operative approach is selected to reach and evacuate the infected collection; the procedure is generally performed in a surgical facility. It is therapeutic drainage, not a prostate biopsy for tissue diagnosis. The transurethral route is represented by a separate code.
Report 55720 when the operative record supports prostate abscess drainage and identifies a non-transurethral approach. Document the abscess, route, operative findings, and drainage performed. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 55720
- 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
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- 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 RVU7.54 · 61%
- Practice expense (office) RVU3.91 · 31%
- Malpractice RVU0.98 · 8%
30
Medicare services in 2024 · #5676 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.
55720 compared with similar codes
Office rates for Idaho, from the same CMS release.
$216.08
55705 describes incisional prostate biopsy, not abscess evacuation. Use 55720 when the operative purpose is drainage.
Compare 55720 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
Idaho →
Office / nonfacility
Unavailable
Facility
$387.48
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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 55720 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
6,372
- Code
- 55720
- Physician work
- 7.54
- Practice expense
- 3.91
- Malpractice
- 0.98
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.54 | × 1.000 | 7.5400 |
| Practice expense | 3.91 | × 0.920 | 3.5972 |
| Malpractice | 0.98 | × 0.473 | 0.4635 |
| Total RVUs | 11.6007 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Idaho$387.48
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.54 | 1 |
| Practice expense | 3.91 | 0.92 |
| Malpractice | 0.98 | 0.473 |
(7.54 × 1 + 3.91 × 0.92 + 0.98 × 0.473) × $33.4009 = $387.48
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.
55720 billing questions
How do I choose between 55720 and 55725?
Use 55720 for prostate abscess drainage by a non-transurethral route. Use 55725 when the drainage is performed transurethrally.
Is this a prostate biopsy code?
No. It reports therapeutic drainage of an abscess. Prostate biopsy codes describe tissue sampling for diagnosis.
What should the operative note document?
Document the prostate abscess, the approach used, operative findings, and the drainage performed. The approach is especially important in distinguishing 55720 from 55725.
Does the code include postoperative care?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days after surgery.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, with other procedures subject to the standard multiple-procedure reduction.
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.
6,36955713,,Bx prst8 in-bore ct/mri bx 1,A,,4.00,18.38,,1.06,,0.50,22.88,5.56,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,37055714,,Bx prst8 in-bore ct/mri 1,A,,3.62,18.24,,0.98,,0.46,22.32,5.06,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,37155715,,Bx prst8 ea add mri-us/ct/mr,A,,1.05,1.24,,0.22,,0.14,2.43,1.41,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,37255720,,Drainage of prostate abscess,A,,7.54,3.91,NA,3.91,,0.98,12.43,12.43,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,37355725,,Drainage of prostate abscess,A,,9.80,5.30,NA,5.30,,1.27,16.37,16.37,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,37455801,,Removal of prostate,A,,19.31,7.65,NA,7.65,,2.48,29.44,29.44,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,37555810,,Extensive prostate surgery,A,,23.68,8.16,NA,8.16,,3.04,34.88,34.88,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772