$340.83
55707 describes transrectal ultrasound-guided prostate biopsy. Choose 55711 when MRI-ultrasound fusion is used to target the lesion.
On this page
CMS RVU26D · Effective 2026-10-01
55711 Prostate biopsy Medicare reimbursement rates in Minnesota
Reports transrectal prostate biopsy using MRI-ultrasound fusion to target and sample the first suspicious lesion identified on prostate imaging. Compare 55711 office and facility rates across CMS payment localities in Minnesota.
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 55711 in Minnesota?
Minnesota 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
$366.97
1 of 1 localities have a supported rate.
Payment area: Minnesota
One mapped payment locality.
Facility setting
$128.44
1 of 1 localities have a supported rate.
Payment area: Minnesota
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
About 55711: Transrectal MRI-ultrasound fusion prostate biopsy
Reports transrectal prostate biopsy using MRI-ultrasound fusion to target and sample the first suspicious lesion identified on prostate imaging.
A urologist uses transrectal ultrasound fused with previously obtained prostate MRI images to guide a needle to the first suspicious lesion and collect tissue samples. This approach is commonly used when prostate MRI identifies a target, such as during evaluation of an elevated PSA or after a prior biopsy. The code represents the first lesion sampled through this transrectal fusion technique, not each needle core.
Report the code when the documented biopsy uses MRI-ultrasound image fusion and samples a target through the rectum. Record the approach, fusion guidance, target lesion, and sampling performed; use 55715 for each additional lesion when applicable. CMS assigns 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. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted. Bilateral adjustment does not apply.
CMS billing rules for 55711
- 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 RVU2.61 · 24%
- Practice expense (office) RVU8.04 · 73%
- Malpractice RVU0.35 · 3%
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.
55711 compared with similar codes
Office rates for Minnesota, from the same CMS release.
$611.45
Both involve MRI-ultrasound fusion and the first target lesion; 55711 is transrectal, while 55712 uses a transperineal approach.
$770.26
55713 is for in-bore CT or MRI-guided biopsy. 55711 uses fused MRI and real-time ultrasound guidance.
Compare 55711 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
Minnesota →
Office / nonfacility
$366.97
Facility
$128.44
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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 55711 in Minnesota.
PPRRVU2026_Oct_nonQPP.csv
6,367
- Code
- 55711
- Physician work
- 2.61
- Practice expense
- 8.04
- Malpractice
- 0.35
GPCI2026.csv
66
- Locality
- Minnesota
- Physician work
- 1.000
- Practice expense
- 1.029
- Malpractice
- 0.296
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.61 | × 1.000 | 2.6100 |
| Practice expense | 8.04 | × 1.029 | 8.2732 |
| Malpractice | 0.35 | × 0.296 | 0.1036 |
| Total RVUs | 10.9868 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Minnesota$366.97
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.61 | 1 |
| Practice expense | 8.04 | 1.029 |
| Malpractice | 0.35 | 0.296 |
(2.61 × 1 + 8.04 × 1.029 + 0.35 × 0.296) × $33.4009 = $366.97
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.61 | 1 |
| Practice expense | 1.1 | 1.029 |
| Malpractice | 0.35 | 0.296 |
(2.61 × 1 + 1.1 × 1.029 + 0.35 × 0.296) × $33.4009 = $128.44
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.
55711 billing questions
When should 55711 be chosen instead of 55707?
Use 55711 when the transrectal biopsy uses MRI-ultrasound fusion to target an MRI-identified lesion. Code 55707 describes transrectal biopsy with ultrasound guidance without the MRI-fusion distinction.
Does each core from the first target support another unit?
No. The code covers sampling the first lesion; multiple cores from that same target do not turn it into multiple lesions.
How is a second MRI target reported?
Use 55715 for each additional lesion sampled, when the service meets that add-on code’s requirements.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inapplicable for this code, and modifier 50 is inappropriate for the prostate biopsy.
What documentation supports 55711?
Document the transrectal route, MRI-ultrasound fusion guidance, the target lesion, and the biopsy sampling 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 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.
6,36455708,,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
6,37055714,,Bx prst8 in-bore ct/mri 1,A,,3.62,18.24,,0.98,,0.46,22.32,5.06,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6314212,MA,99,REST OF MASSACHUSETTS,1.016,1.053,0.797
6408202,MI,01,DETROIT,1.000,0.965,1.686
6508202,MI,99,REST OF MICHIGAN,1.000,0.913,1.129
6606202,MN,00,MINNESOTA,1.000,1.029,0.296
6707302,MS,00,MISSISSIPPI,1.000,0.861,0.739
6805302,MO,02,METROPOLITAN KANSAS CITY,1.000,0.939,0.977
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002