Billing code 55706: Prostate biopsyMedicare rate & RVUs in Oklahoma
Reports extensive needle sampling of the prostate to evaluate suspected cancer, including imaging guidance used during the saturation biopsy.
CMS doesn’t publish an office rate for 55706 in Oklahoma.
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 55706 covers
55706 represents extensive needle sampling across the prostate to evaluate suspected malignancy, often when concern persists after an earlier biopsy. A urologist typically performs the procedure in an office-based procedure room or facility, using a planned sampling pattern; imaging guidance may be used. The code describes saturation sampling rather than a particular needle-entry route.
Choose 55706 for saturation sampling rather than a conventional biopsy or a biopsy defined by a specific imaging-targeting method. Imaging guidance used for the saturation biopsy is included. Document the indication, approach, sampling pattern and extent, and guidance used. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 is inappropriate for this service. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is 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.
55706 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | Unavailable | $194.46 |
How the 55706 rate is calculated
Each of 55706’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 · 55706
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.16Practice expense 1.40Malpractice 0.53
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 55706
The CMS indicators that decide how 55706 is paid alongside other services.
CMS payment indicators · 55706
Prostate biopsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
55706 without 51 · national facility
$203.41
Prostate biopsy
55706-51 · Second procedure: 50%
$101.71
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%).
55706 compared with similar codes
Compare codes
55706 vs 55705 vs 55707 vs 55709: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 55705Prostate biopsy
- 55705 describes a prostate needle biopsy by a non-imaging approach. Use 55706 when the service is saturation sampling, with imaging guidance included when performed.
- 55707Prostate biopsy
- 55707 is an ultrasound-guided biopsy through a transrectal approach. 55706 identifies saturation sampling rather than that specific approach.
- 55709Prostate biopsy
- 55709 identifies ultrasound-guided biopsy through a transperineal approach. 55706 is selected for saturation sampling, not solely because of the needle-entry route.
55706 billing questions
When should 55706 be selected instead of a conventional prostate biopsy code?
Use 55706 when the service is extensive saturation sampling, commonly after a prior biopsy has not resolved persistent concern. A conventional or approach-specific biopsy may fit a different sampling method.
Can imaging guidance be billed separately for the saturation biopsy?
Imaging guidance used for the saturation sampling is included in 55706. Document the guidance used as part of the biopsy service.
Should modifier 50 be appended for bilateral prostate sampling?
No. Modifier 50 is inappropriate for 55706.
Does the 0-day global period include same-day care?
Yes. Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
How should the number of needle cores be reported?
The code represents the saturation-sampling service, not a separate unit for each core. Document the sampling pattern and extent performed.
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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