Billing code 53860: Prostate treatmentMedicare rate & RVUs in Oklahoma
Reports transurethral radiofrequency treatment of prostate tissue, typically for urinary symptoms associated with benign prostatic enlargement.
Medicare pays $2,147.58 for 53860 in the office in Oklahoma (Oklahoma). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 53860 covers
A urologist delivers radiofrequency energy to prostate tissue through a transurethral instrument to treat enlargement-related urinary obstruction. The treatment is performed in an office or other outpatient setting; the instrument and treatment method distinguish it from microwave thermotherapy, water-vapor treatment, and tissue resection. The clinical record should support the prostate condition being treated and describe the procedure and radiofrequency technique used.
Report the code for the transurethral radiofrequency treatment itself, with documentation identifying the treated tissue and method. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
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.
53860 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | $2,147.58 | $192.13 |
How the 53860 rate is calculated
Each of 53860’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 53860
RVUs × geographic indexes × conversion factor
Work3.87
3.87 RVUs× 1.000 GPCI
Practice expense67.25
67.25 RVUs× 1.000 GPCI
Malpractice0.48
0.48 RVUs× 1.000 GPCI
Adjusted RVUs
71.6000
Conversion factor
$33.4009
Medicare rate
$2,391.50
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 53860
53860 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 53860
Prostate treatment
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.08/0.83/0.09 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 53860
Prostate treatment
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
53860 without 51 · national office
$2,391.50
Prostate treatment
53860-51 · Second procedure: 50%
$1,195.75
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
53860 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 53852Prostate ablation
- Both describe transurethral radiofrequency treatment of prostate tissue, but 53852 specifies radiofrequency thermotherapy. Base code selection on the documented procedure technique.
- 53850Prostate treatment
- This code identifies microwave thermotherapy of prostate tissue, not transurethral radiofrequency treatment.
- 53854Prostate ablation
- This code identifies treatment using radiofrequency-generated water vapor, a different method from the radiofrequency treatment reported with 53860.
53860 billing questions
How does this differ from 53852?
Both involve transurethral radiofrequency treatment of prostate tissue. Use the code that matches the specific procedure and technique documented; 53852 identifies radiofrequency thermotherapy.
Can this be reported with microwave or water-vapor treatment?
Those are distinct treatment methods, represented by 53850 for microwave thermotherapy and 53854 for radiofrequency-generated water-vapor thermotherapy. Select the code for the method actually performed.
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 be used?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
When is an assistant-at-surgery payment allowed?
Only when medical necessity for the assistant is documented. Co-surgeons and team surgery are not permitted for this code.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in the same session 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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