$366.97
55711 represents the first lesion sampled with transrectal MRI-US guidance. Use 55715 for each additional distinct lesion sampled in the applicable guided-biopsy session.
On this page
CMS RVU26D · Effective 2026-10-01
55715 Prostate biopsy Medicare reimbursement rates in Minnesota
Reports sampling of each additional prostate lesion targeted with MRI-US fusion or CT/MR guidance during a guided prostate biopsy. Compare 55715 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 55715 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
$79.07
1 of 1 localities have a supported rate.
Payment area: Minnesota
One mapped payment locality.
Facility setting
$44.02
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 procedure
About 55715: Additional MRI-guided prostate lesion biopsy
Reports sampling of each additional prostate lesion targeted with MRI-US fusion or CT/MR guidance during a guided prostate biopsy.
This add-on represents sampling an additional distinct prostate lesion after the primary lesion in a biopsy performed with MRI-US fusion or CT/MR guidance. A urologist typically uses MRI findings to identify targets and obtain tissue cores from them in an outpatient procedure room or hospital setting. The additional lesion may be sampled during the same session as systematic cores, but those cores alone do not establish an additional targeted lesion.
Report this code with the applicable primary procedure for the guided biopsy, such as the first-lesion codes 55711–55714. The record should identify the additional target and support that it was sampled; count distinct lesions, not the number of cores taken from one lesion. This is an add-on code, not a stand-alone service, and Medicare pays it within the primary procedure’s global period.
CMS billing rules for 55715
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU1.05 · 43%
- Practice expense (office) RVU1.24 · 51%
- Malpractice RVU0.14 · 6%
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.
55715 compared with similar codes
Office rates for Minnesota, from the same CMS release.
$611.45
55712 represents the first lesion sampled with transperineal MRI-US guidance. This code is for additional distinct lesions, not the initial target.
$770.26
55713 represents the first lesion in an in-bore CT/MRI-guided biopsy. This code accounts for additional distinct lesion sampling.
No office rate
55706 describes transperineal template-guided saturation sampling. It is not the additional-lesion code for an MRI-US fusion or CT/MR-guided biopsy.
Compare 55715 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
$79.07
Facility
$44.02
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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 55715 in Minnesota.
PPRRVU2026_Oct_nonQPP.csv
6,371
- Code
- 55715
- Physician work
- 1.05
- Practice expense
- 1.24
- Malpractice
- 0.14
GPCI2026.csv
66
- Locality
- Minnesota
- Physician work
- 1.000
- Practice expense
- 1.029
- Malpractice
- 0.296
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.05 | × 1.000 | 1.0500 |
| Practice expense | 1.24 | × 1.029 | 1.2760 |
| Malpractice | 0.14 | × 0.296 | 0.0414 |
| Total RVUs | 2.3674 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Minnesota$79.07
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.05 | 1 |
| Practice expense | 1.24 | 1.029 |
| Malpractice | 0.14 | 0.296 |
(1.05 × 1 + 1.24 × 1.029 + 0.14 × 0.296) × $33.4009 = $79.07
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.05 | 1 |
| Practice expense | 0.22 | 1.029 |
| Malpractice | 0.14 | 0.296 |
(1.05 × 1 + 0.22 × 1.029 + 0.14 × 0.296) × $33.4009 = $44.02
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.
55715 billing questions
When is this code reported instead of a first-lesion code?
Use it for an additional distinct lesion sampled during an MRI-US fusion or CT/MR-guided prostate biopsy. The applicable primary code represents the first lesion.
Which primary procedure codes can it accompany?
Pair it with the applicable primary guided-biopsy code, including the first-lesion codes 55711–55714. It cannot be reported by itself.
Are additional cores from one target separately counted?
No. The unit is based on an additional distinct lesion sampled, not the number of cores obtained from that lesion.
What documentation supports an additional lesion?
Document the additional target, its identification through the guided-biopsy process, and that tissue was sampled from it.
How does Medicare treat payment for this add-on?
Medicare pays it only with a primary procedure and within that procedure’s global period.
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.
6,36855712,,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
6,37155715,,Bx prst8 ea add mri-us/ct/mr,A,,1.05,1.24,,0.22,,0.14,2.43,1.41,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,37255720,,Drainage of prostate abscess,A,,7.54,3.91,NA,3.91,,0.98,12.43,12.43,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,37355725,,Drainage of prostate abscess,A,,9.80,5.30,NA,5.30,,1.27,16.37,16.37,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,37455801,,Removal of prostate,A,,19.31,7.65,NA,7.65,,2.48,29.44,29.44,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,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