No office rate
Both describe perineal radical prostatectomy, but 55812 includes bilateral pelvic lymphadenectomy. Choose 55810 when that lymphadenectomy is not performed.
On this page
CMS RVU26D · Effective 2026-10-01
55812 Radical prostatectomy Medicare reimbursement rates in Nevada
Reports radical removal of the prostate through a perineal approach when bilateral pelvic lymphadenectomy is performed during the same operative service. Compare 55812 office and facility rates across CMS payment localities in Nevada.
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 55812 in Nevada?
Nevada 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
No supported rate
Facility setting
$1409.98
1 of 1 localities have a supported rate.
Payment area: Nevada**
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.
Urologic surgery
About 55812: Perineal radical prostatectomy with pelvic lymphadenectomy
Reports radical removal of the prostate through a perineal approach when bilateral pelvic lymphadenectomy is performed during the same operative service.
This code describes radical prostate removal through an incision in the perineum, together with removal of lymph nodes from both sides of the pelvis. Urologists typically perform the operation in a hospital operating room for prostate cancer. The operative report should establish the perineal approach and document the bilateral lymphadenectomy performed as part of the surgical service.
Choose this code when both the perineal radical prostatectomy and bilateral pelvic lymphadenectomy are performed; a perineal radical prostatectomy without lymphadenectomy is a different code. The lymphadenectomy is included in this combined service, rather than separately reported as a second service for the same work. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this operation. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 55812
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU29.14 · 68%
- Practice expense (office) RVU9.94 · 23%
- Malpractice RVU3.75 · 9%
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.
55812 compared with similar codes
Office rates for Nevada, from the same CMS release.
No office rate
This is a neighboring perineal prostatectomy code for a more specifically described extent of pelvic node dissection. Compare the operative report’s documented nodal extent when selecting between the codes.
No office rate
55842 describes a retropubic radical prostatectomy with bilateral pelvic lymphadenectomy. 55812 is for the perineal approach.
No office rate
55866 describes laparoscopic radical prostatectomy; 55812 describes the perineal operation with bilateral pelvic lymphadenectomy.
Compare 55812 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
Nevada** →
Office / nonfacility
Unavailable
Facility
$1409.98
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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 55812 in Nevada**.
PPRRVU2026_Oct_nonQPP.csv
6,376
- Code
- 55812
- Physician work
- 29.14
- Practice expense
- 9.94
- Malpractice
- 3.75
GPCI2026.csv
73
- Locality
- Nevada**
- Physician work
- 1.000
- Practice expense
- 1.001
- Malpractice
- 0.833
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 29.14 | × 1.000 | 29.1400 |
| Practice expense | 9.94 | × 1.001 | 9.9499 |
| Malpractice | 3.75 | × 0.833 | 3.1237 |
| Total RVUs | 42.2137 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nevada**$1409.98
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 29.14 | 1 |
| Practice expense | 9.94 | 1.001 |
| Malpractice | 3.75 | 0.833 |
(29.14 × 1 + 9.94 × 1.001 + 3.75 × 0.833) × $33.4009 = $1409.98
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.
55812 billing questions
How does this differ from 55810?
55812 includes bilateral pelvic lymphadenectomy with the perineal radical prostatectomy. Use 55810 for the perineal radical prostatectomy without that lymphadenectomy.
Can the pelvic lymphadenectomy be billed separately?
The bilateral pelvic lymphadenectomy is included in 55812 when performed as part of this combined operation. The operative report should document the nodal work performed.
Should modifier 50 be appended?
No. Modifier 50 is inappropriate for this prostate operation; bilateral lymphadenectomy is part of the code’s described service.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.
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.
6,37355725,,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
6,37555810,,Extensive prostate surgery,A,,23.68,8.16,NA,8.16,,3.04,34.88,34.88,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,37655812,,Extensive prostate surgery,A,,29.14,9.94,NA,9.94,,3.75,42.83,42.83,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,37755815,,Extensive prostate surgery,A,,32.13,10.56,NA,10.56,,4.13,46.82,46.82,0,090,0.10,0.80,0.10,2,2,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,37855821,,Removal of prostate,A,,14.80,5.90,NA,5.90,,1.91,22.61,22.61,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,37955831,,Removal of prostate,A,,15.21,5.99,NA,5.99,,2.00,23.20,23.20,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068
7612402,NJ,99,REST OF NEW JERSEY,1.040,1.092,1.097