Billing code 53850: Prostate treatmentMedicare rate & RVUs in Illinois
Urologists report transurethral microwave thermotherapy to heat obstructive prostate tissue as a minimally invasive treatment for lower urinary tract symptoms from benign prostatic enlargement.
Medicare pays $1,332.94–$1,478.90 for 53850 in the office in Illinois, from Rest Of Illinois to Suburban Chicago. 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 53850 covers
During transurethral microwave thermotherapy, a urologist passes a treatment catheter through the urethra and delivers microwave energy to heat prostate tissue contributing to bladder-outlet obstruction. The procedure is used for men with bothersome lower urinary tract symptoms associated with benign prostatic enlargement, such as weak stream, hesitancy, or frequency. It is generally performed in an outpatient urology setting.
Report this code for the microwave treatment, not for radiofrequency or water-vapor prostate therapy. Documentation should identify the prostate condition, symptoms, and treatment method. The 90-day global includes the day-before preoperative visit and related postoperative care during the 90 days after surgery. When other procedures occur in the same session, the highest-valued procedure is paid in full and additional procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery services are not paid, and co-surgeons and team surgery 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.
Where 53850 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$1332.94 to $1478.90
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $1,463.58 | $361.88 |
| East St. Louis | $1,351.63 | $343.11 |
| Rest Of Illinois | $1,332.94 | $332.09 |
| Suburban Chicago | $1,478.90 | $353.08 |
How the 53850 rate is calculated
Each of 53850’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 · 53850
RVUs × geographic indexes × conversion factor
Work5.28
5.28 RVUs× 1.000 GPCI
Practice expense36.78
36.78 RVUs× 1.000 GPCI
Malpractice0.67
0.67 RVUs× 1.000 GPCI
Adjusted RVUs
42.7300
Conversion factor
$33.4009
Medicare rate
$1,427.22
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 53850
53850 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 53850
Prostate treatment
| 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) | 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. |
| Split (54/55/56) | 0.08/0.83/0.09 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 53850
Prostate treatment
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
53850 without 51 · national office
$1,427.22
Prostate treatment
53850-51 · Second procedure: 50%
$713.61
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%).
53850 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 53852Prostate ablation
- Choose 53850 for microwave thermotherapy and 53852 for radiofrequency thermotherapy; the energy-delivery method distinguishes the procedures.
- 53854Prostate ablation
- billing code 53854 uses radiofrequency-generated water vapor to destroy prostate tissue, while 53850 uses microwave energy delivered by a treatment catheter.
- 52601TURP
- billing code 52601 represents transurethral resection of prostate tissue. billing code 53850 is microwave thermotherapy, not tissue resection.
53850 billing questions
How does this differ from billing code 53852?
billing code 53850 is for microwave thermotherapy. billing code 53852 is for transurethral radiofrequency thermotherapy.
How does this differ from billing code 53854?
billing code 53854 describes prostate tissue destruction using radiofrequency-generated water vapor. billing code 53850 uses microwave energy delivered through a treatment catheter.
Should modifier 50 be appended?
No. The descriptor and anatomy make bilateral adjustment inappropriate.
What postoperative care is included?
The 90-day global includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
What should the record support?
Document the prostate condition and symptoms, and identify microwave thermotherapy as the treatment performed.
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
Fee sheets
Put 53850 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →