$1,151.21–$1,229.38
Use 53865 for temporary-device placement that reshapes the prostatic urethra through ischemic remodeling. Code 52441 describes placement of a permanent adjustable implant.
On this page
CMS RVU26D · Effective 2026-10-01
53865 Prostate remodeling Medicare reimbursement rates in Maine
A urologist inserts a temporary transprostatic remodeling device cystoscopically to reshape the prostatic urethra in patients treated for urinary obstruction. Compare 53865 office and facility rates across CMS payment localities in Maine.
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 53865 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$2843.84–$3055.02
2 of 2 localities have a supported rate.
Facility setting
$138.17–$140.54
2 of 2 localities have a supported rate.
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 procedure
About 53865: Temporary prostatic remodeling device insertion
A urologist inserts a temporary transprostatic remodeling device cystoscopically to reshape the prostatic urethra in patients treated for urinary obstruction.
A urologist passes a cystoscope through the urethra and places a temporary implant in the prostatic urethra. The device applies pressure that produces localized ischemic remodeling, creating channels through obstructing prostate tissue. The procedure is used for lower urinary tract symptoms related to benign prostatic enlargement and is performed in an outpatient procedural setting under cystoscopic visualization. The device is removed in a later procedure.
Report 53865 for the insertion procedure, supported by documentation of the indication, cystoscopic placement, and device insertion. Same-day preoperative and postoperative care is included in its 0-day global period. When related endoscopies are performed together, CMS endoscopy-family pricing applies. Modifier 50 is inappropriate for this service. Medicare does not pay for an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 53865
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Endoscopy family pricing applies when related endoscopies are performed together.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.02 · 3%
- Practice expense (office) RVU89.00 · 96%
- Malpractice RVU0.39 · 0%
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.
53865 compared with similar codes
Office rates for Maine, from the same CMS release.
$135.93–$142.47
Code 53865 reports device insertion; code 53866 reports removal of the previously placed remodeling device.
$1,320.48–$1,407.91
Code 53850 is microwave thermotherapy of the prostate. Code 53865 is cystoscopic placement of a temporary implant, not thermal treatment.
$3,131.87–$3,357.69
Code 53854 treats prostate tissue with water-vapor ablation. Code 53865 uses a temporary implant to produce ischemic remodeling.
Compare 53865 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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
$2843.84
Facility
$138.17
Southern Maine →
Office / nonfacility
$3055.02
Facility
$140.54
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53865 billing questions
How does this differ from code 52441?
Code 53865 describes placement of a temporary device that reshapes the prostatic urethra through ischemic remodeling. Code 52441 is for insertion of a permanent adjustable transprostatic implant.
Is the later device removal included?
No. Removal is a separate procedure reported with code 53866, rather than part of the insertion service.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this service.
Can an assistant or co-surgeon be reported?
Medicare does not pay for an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What happens when another endoscopy is performed in the same session?
When related endoscopies are performed together, CMS endoscopy-family pricing applies. The claim should reflect the procedures actually performed and documented.
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.
6,22953854,,Trurl dstrj prst8 tiss rf wv,A,,5.78,95.13,,4.07,,0.75,101.66,10.60,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,23053855,,Insert prost urethral stent,A,,1.60,17.77,,0.34,,0.21,19.58,2.15,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,23153860,,Transurethral rf treatment,A,,3.87,67.25,,1.69,,0.48,71.60,6.04,0,090,0.08,0.83,0.09,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,23253865,,Cysto insj dev ischmc rmdlg,A,,3.02,89.00,,0.95,,0.39,92.41,4.36,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,23353866,,Cathj rmvl dev ischmc rmdlg,A,,1.44,2.73,,0.58,,0.19,4.36,2.21,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,23453899,,Unlisted px urinary system,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
6,23554000,,Slitting of prepuce,A,,1.55,3.26,,1.39,,0.20,5.01,3.14,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00