Billing code 55865: ProstatectomyMedicare rate & RVUs in Minooka, Illinois

Compare Medicare physician payments in Minooka, IL. Census city boundaries cover Grundy County, Kendall County, Will County. Use the service ZIP to confirm the payment locality for a specific address.

CMS RVU26DEffective Oct 1, 20262 payment localities

CMS doesn’t publish an office rate for 55865 in Minooka, Illinois.

—Office (non-facility)

$1,223.51–$1,283.37Hospital or facility

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 6 sections

Rate in Minooka, Illinois
By payment locality
City and payment areas
How it’s calculated
Payment rules
Sources

Where 55865 pays more and less in Minooka, Illinois

Minooka, Illinois maps to 2 Medicare payment localities in our Census-to-CMS crosswalk. A city name alone doesn’t confirm an address’s payment area.

55865 office and facility rates by payment locality
Payment locality	Office	Facility
Rest Of Illinois	Unavailable	$1,223.51
Suburban Chicago	Unavailable	$1,283.37

How payment areas work in Minooka

City limits and Medicare payment areas are different maps. These are the payment areas that cover the city’s counties; the service ZIP decides which one applies.

Rest of Illinois · Grundy County, Kendall County
Suburban Chicago · Will County

City boundaries: 2026 Census geography · Census source · CMS county-to-locality definitions

How the 55865 rate is calculated

Each of 55865’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 · 55865

RVUs × geographic indexes × conversion factor

Your ZIP

Work23.96

23.96 RVUs× 1.000 GPCI

Practice expense8.64

8.64 RVUs× 1.000 GPCI

Malpractice3.06

3.06 RVUs× 1.000 GPCI

Adjusted RVUs

35.6600

Conversion factor

$33.4009

Medicare rate

$1,191.08

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 55865

55865 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 55865

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)	2	Already bilateral by definition: paid once at 100%.
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 · 55865

Prostatectomy

Date of surgery

Date of a later visit

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.

24Unrelated E/M visit by the same physician
79Unrelated procedure (starts its own global period)
58Staged, more extensive, or therapy procedure that was planned
78Unplanned return to the operating room for a related complication

SurgeryVisit

Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

55865 without 51 · national facility

$1,191.08

Prostatectomy

55865-51 · Second procedure: 50%

$595.54

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%).

When to use modifier 51

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

RVUs for 55865PPRRVU2026_Oct_nonQPP.csv, line 6,385 (RVU26D)

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

Open CMS source How we calculate rates

Fee sheets

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Where 55865 pays more and less in Minooka, Illinois

How payment areas work in Minooka

How the 55865 rate is calculated

Payment rules and modifiers for 55865

What modifiers do to the payment

Where these rates come from

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