No office rate
Use 55873 for prostate tissue treated by freezing. Code 55880 describes ablation using high-intensity focused ultrasound.
On this page
CMS RVU26D · Effective 2026-10-01
55873 Prostate cryoablation Medicare reimbursement rates in Missouri
Reports prostate tissue destruction by cryotherapy, typically for localized prostate cancer or recurrent disease, with ultrasound guidance and monitoring included. Compare 55873 office and facility rates across CMS payment localities in Missouri.
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 55873 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
$4973.53–$5442.40
3 of 3 localities have a supported rate.
Facility setting
$660.84–$679.43
3 of 3 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.
Where 55873 pays more and less in Missouri
3 payment localities
$4973.53 to $5442.40
Urology procedure
About 55873: Prostate cryoablation for malignancy
Reports prostate tissue destruction by cryotherapy, typically for localized prostate cancer or recurrent disease, with ultrasound guidance and monitoring included.
A urologist uses probes placed through the perineum to freeze prostate tissue, with ultrasound used to guide and monitor treatment. The procedure is commonly performed in a hospital or ambulatory surgery setting for localized prostate cancer, including selected cases treated after recurrence following radiation. The treatment may target the gland or a defined area, depending on the clinical plan.
Report the service when the documented procedure uses cryotherapy to ablate prostate tissue; the operative note should identify the indication, treatment extent, probe placement, and freezing process. Ultrasound guidance and monitoring are included in the service. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 55873
- 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
- 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 RVU13.26 · 8%
- Practice expense (office) RVU155.45 · 91%
- Malpractice RVU1.69 · 1%
1.3K
Medicare services in 2024 · #2802 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.
55873 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
Use 55873 when cryotherapy is performed. Code 55877 is for percutaneous prostate tumor ablation using irreversible electroporation.
No office rate
Code 55866 reports laparoscopic radical removal of the prostate; 55873 reports ablation that leaves the prostate in place.
Compare 55873 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
$5373.49
Facility
$675.56
Metropolitan St. Louis →
Office / nonfacility
$5442.40
Facility
$679.43
Rest Of Missouri →
Office / nonfacility
$4973.53
Facility
$660.84
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55873 billing questions
How does this differ from prostate HIFU ablation?
This code is for cryotherapy, which destroys tissue by freezing. HIFU uses focused ultrasound energy and is reported with the code specific to that technique.
Can ultrasound guidance be billed separately?
Ultrasound guidance and monitoring are included in the cryoablation service. Do not separately report them for guidance or monitoring integral to this procedure.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can modifier 50 or an assistant-at-surgery modifier be used?
Modifier 50 is inappropriate for this prostate procedure. Medicare does not pay an assistant at surgery for this service.
What should the operative note support?
Document the prostate condition treated, the extent of tissue targeted, probe placement, and the cryotherapy performed. The record should also support that the treatment used freezing rather than another ablation method.
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.
6,38855868,,Lap srg prst8ct lymph nod bx,A,,22.46,7.79,NA,7.79,,2.91,33.16,33.16,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,38955869,,Lap srg prst8ct bi pl lmphad,A,,27.41,8.82,NA,8.82,,3.55,39.78,39.78,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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