$3,304.52
Use 55875 for needles or catheters placed for interstitial radioactive treatment. Code 55874 concerns transperineal placement of biodegradable material, such as a prostate spacer.
On this page
CMS RVU26D · Effective 2026-10-01
55875 Prostate brachytherapy Medicare reimbursement rates in Kentucky
Reports transperineal placement of needles or catheters in the prostate to support interstitial radiation treatment, commonly for localized prostate cancer. Compare 55875 office and facility rates across CMS payment localities in Kentucky.
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 55875 in Kentucky?
Kentucky 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
$661.26
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 55875: Transperineal prostate brachytherapy needle placement
Reports transperineal placement of needles or catheters in the prostate to support interstitial radiation treatment, commonly for localized prostate cancer.
A urologist places needles or catheters through the perineum into the prostate so radioactive material can be used for interstitial treatment. A common setting is an operating room or outpatient surgical facility for prostate brachytherapy. The urologist may perform the placement with a radiation oncologist involved in the treatment plan; the code allows placement with or without cystoscopy. This is the placement service, not the radiation source application itself.
Select the code when the operative record supports transperineal prostate needle or catheter placement for interstitial radioelement treatment. Document the treatment purpose and the placement performed; do not substitute prostate marker placement or biodegradable spacer placement. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 55875
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU13.12 · 64%
- Practice expense (office) RVU6.05 · 29%
- Malpractice RVU1.42 · 7%
5.2K
Medicare services in 2024 · #1841 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.
55875 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$140.94
Use 55876 for prostate radiotherapy marker or device placement. Use 55875 when needles or catheters are placed to support interstitial radioelement treatment.
$5,110.38
Code 55873 describes prostate cryoablation, not placement for interstitial radiation treatment.
No office rate
Code 55866 describes laparoscopic radical prostatectomy. It represents surgical removal of the prostate rather than brachytherapy access placement.
Compare 55875 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$661.26
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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 55875 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
6,393
- Code
- 55875
- Physician work
- 13.12
- Practice expense
- 6.05
- Malpractice
- 1.42
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.12 | × 1.000 | 13.1200 |
| Practice expense | 6.05 | × 0.889 | 5.3784 |
| Malpractice | 1.42 | × 0.915 | 1.2993 |
| Total RVUs | 19.7977 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$661.26
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.12 | 1 |
| Practice expense | 6.05 | 0.889 |
| Malpractice | 1.42 | 0.915 |
(13.12 × 1 + 6.05 × 0.889 + 1.42 × 0.915) × $33.4009 = $661.26
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.
55875 billing questions
When should I report 55875 rather than 55876?
Report 55875 for transperineal needle or catheter placement to support interstitial radioactive treatment. Code 55876 describes prostate placement of radiotherapy markers or a device, not brachytherapy needle placement.
Is radioactive source application included in 55875?
55875 represents the prostate needle or catheter placement. Radiation source application, such as the service represented by 77778 when applicable, is a separate treatment service.
Can modifier 50 be used for placement on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; do not use modifier 50 to report bilateral placement.
What global period applies?
This is major surgery with a 90-day global period. The day-before preoperative visit and 90 days of related postoperative care are included.
How is 55875 affected when other procedures occur in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. Assistant-at-surgery payment requires medical-necessity documentation, and co-surgeons and team surgery are not permitted.
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.
6,39055870,,Electroejaculation,A,,2.52,2.70,,0.97,,0.33,5.55,3.82,0,000,0.00,0.00,0.00,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,39155873,,Cryoablate prostate,A,,13.26,155.45,,5.66,,1.69,170.40,20.61,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,39255874,,Tprnl plmt biodegrdabl matrl,A,,2.95,107.63,,0.99,,0.33,110.91,4.27,0,000,0.00,0.00,0.00,2,0,1,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
6,39355875,,Transperi needle place pros,A,,13.12,6.05,NA,6.05,,1.42,20.59,20.59,0,090,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,39455876,,Place rt device/marker pros,A,,1.69,2.65,,0.84,,0.19,4.53,2.72,0,000,0.00,0.00,0.00,2,0,1,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
6,39555877,,Abltj ire prst8 1+ tum perq,A,,13.50,4.99,NA,4.99,,1.61,20.10,20.10,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,39655880,,Abltj mal prst8 tiss hifu,A,,17.29,6.83,NA,6.83,,2.21,26.33,26.33,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631