No office rate
This code is for the open retropubic approach. Choose 55810 when the radical prostatectomy is performed through the perineal approach.
On this page
CMS RVU26D · Effective 2026-10-01
55840 Radical prostatectomy Medicare reimbursement rates in Ohio
Reports open retropubic removal of the prostate for radical treatment, with or without nerve sparing, when the separately defined lymphadenectomy variants are not performed. Compare 55840 office and facility rates across CMS payment localities in Ohio.
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 55840 in Ohio?
Ohio 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
$1023.35
1 of 1 localities have a supported rate.
Payment area: Ohio
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 55840: Open retropubic radical prostatectomy
Reports open retropubic removal of the prostate for radical treatment, with or without nerve sparing, when the separately defined lymphadenectomy variants are not performed.
A urologist typically performs this open operation through a lower abdominal incision to remove the prostate as radical treatment, commonly for prostate cancer. Nerve-sparing dissection may be performed when clinically appropriate. This code identifies the retropubic approach without the bilateral pelvic lymphadenectomy variants in the same code family; the operative report should support the approach, extent of prostate removal, and whether nerve sparing was performed.
Report the code when the documented operation matches the open retropubic radical procedure, rather than a perineal or laparoscopic approach or a lymphadenectomy variant. CMS assigns a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 55840
- 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 RVU20.83 · 67%
- Practice expense (office) RVU7.74 · 25%
- Malpractice RVU2.72 · 9%
967
Medicare services in 2024 · #2998 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.
55840 compared with similar codes
Office rates for Ohio, from the same CMS release.
No office rate
Both are retropubic radical prostatectomy codes; 55842 identifies the variant that includes bilateral pelvic lymphadenectomy.
No office rate
55866 describes laparoscopic radical prostatectomy. Use 55840 for the open retropubic operation.
Compare 55840 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
Ohio →
Office / nonfacility
Unavailable
Facility
$1023.35
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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 55840 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
6,380
- Code
- 55840
- Physician work
- 20.83
- Practice expense
- 7.74
- Malpractice
- 2.72
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 20.83 | × 1.000 | 20.8300 |
| Practice expense | 7.74 | × 0.913 | 7.0666 |
| Malpractice | 2.72 | × 1.008 | 2.7418 |
| Total RVUs | 30.6384 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Ohio$1023.35
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 20.83 | 1 |
| Practice expense | 7.74 | 0.913 |
| Malpractice | 2.72 | 1.008 |
(20.83 × 1 + 7.74 × 0.913 + 2.72 × 1.008) × $33.4009 = $1023.35
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.
55840 billing questions
How is this code distinguished from 55810?
Both describe radical prostatectomy, but 55840 is the open retropubic approach and 55810 is the perineal approach. Use the approach documented in the operative report.
Which code applies when bilateral pelvic lymphadenectomy is performed?
Use the applicable lymphadenectomy variant in the 55840 family, such as 55842 or 55845, rather than reporting 55840 for that operative configuration.
Does nerve sparing change the code selection?
No. This code includes the retropubic radical procedure whether or not nerve-sparing dissection is performed.
What postoperative care is included in the global period?
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?
CMS may pay for an assistant at surgery. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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.
6,37755815,,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
6,38055840,,Extensive prostate surgery,A,,20.83,7.74,NA,7.74,,2.72,31.29,31.29,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,38155842,,Extensive prostate surgery,A,,20.83,7.71,NA,7.71,,2.68,31.22,31.22,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,38255845,,Extensive prostate surgery,A,,24.55,8.49,NA,8.49,,3.17,36.21,36.21,0,090,0.10,0.80,0.10,2,2,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,38355860,,Surgical exposure prostate,A,,15.44,6.11,NA,6.11,,1.98,23.53,23.53,0,090,0.10,0.80,0.10,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703