$539.75–$572.53
Choose 55709 for transperineal ultrasound-guided biopsy without MRI fusion. Choose 55710 when MRI images are fused with ultrasound to target the biopsy.
On this page
CMS RVU26D · Effective 2026-10-01
55710 Prostate biopsy Medicare reimbursement rates in Maine
Reports the first prostate lesion sampled through a transperineal approach using ultrasound guidance fused with MRI images to target the biopsy. Compare 55710 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 55710 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
$605.54–$641.82
2 of 2 localities have a supported rate.
Facility setting
$178.71–$182.06
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 55710: Transperineal MRI-fusion prostate biopsy
Reports the first prostate lesion sampled through a transperineal approach using ultrasound guidance fused with MRI images to target the biopsy.
A urologist uses a transperineal needle route to sample a prostate target while ultrasound images are fused with MRI images for targeting. The service is typically performed in an office-based procedure setting or an outpatient facility. The MRI fusion helps direct the needle toward a lesion identified on prior imaging, rather than relying only on systematic sampling.
Report this code for the first lesion sampled with this transperineal ultrasound-and-MRI fusion technique. Document the transperineal route, fusion guidance, target and lesion count; the fusion and ultrasound guidance are part of the biopsy service. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires medical-necessity documentation; co-surgeons and team surgery are not permitted.
CMS billing rules for 55710
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 RVU3.81 · 20%
- Practice expense (office) RVU15.24 · 78%
- Malpractice RVU0.48 · 2%
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.
55710 compared with similar codes
Office rates for Maine, from the same CMS release.
$390.73–$411.59
Both involve MRI fusion, but 55708 uses a transrectal needle route. 55710 is for the transperineal route.
$341.51–$360.68
55711 describes MRI-ultrasound fusion biopsy through a transrectal route. 55710 is the transperineal route.
Compare 55710 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
$605.54
Facility
$178.71
Southern Maine →
Office / nonfacility
$641.82
Facility
$182.06
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55710 billing questions
How does this differ from 55709?
55710 includes MRI-ultrasound fusion for targeting the sampled lesion. Use 55709 for transperineal ultrasound-guided biopsy without the MRI-fusion service.
How does this differ from 55708?
Both describe MRI-fusion-guided prostate biopsy, but 55710 uses a transperineal route; 55708 uses a transrectal route.
Can I report 55715 with this code?
55715 is the add-on code for each additional lesion in the MRI-fusion biopsy family. Use it when additional lesions are sampled, not simply for additional cores from the first lesion.
Should modifier 50 be appended for bilateral sampling?
No. CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
What documentation supports reporting 55710?
Document the transperineal approach, use of ultrasound with MRI fusion, the lesion targeted, and whether it was the first or an additional lesion sampled.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted under the CMS rules for this code.
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.
6,36355707,,Bx prst8 trct us guided,A,,2.63,7.26,,1.10,,0.35,10.24,4.08,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,36455708,,Bx prst8 trct us w/mri fus 1,A,,3.39,8.74,,1.26,,0.43,12.56,5.08,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,36555709,,Bx prst8 tprnl us guided,A,,3.23,13.77,,1.23,,0.42,17.42,4.88,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,36655710,,Bx prst8 tprn us w/mri fus 1,A,,3.81,15.24,,1.35,,0.48,19.53,5.64,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,36755711,,Bx prst8 trct mri-us 1st,A,,2.61,8.04,,1.10,,0.35,11.00,4.06,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,36855712,,Bx prst8 tprnl mri-us 1st,A,,3.10,14.66,,1.22,,0.41,18.17,4.73,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,36955713,,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