Billing code 55810: Radical prostatectomyMedicare rate & RVUs in Oregon
Reports radical removal of the prostate through a perineal approach, typically for prostate cancer when the operative plan uses this route.
CMS doesn’t publish an office rate for 55810 in Oregon.
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 55810 covers
A urologist removes the prostate through an incision in the perineum as treatment for prostate cancer. Radical prostatectomy includes removal of the prostate and seminal vesicles; nerve-sparing may be performed when clinically appropriate. This is a major operation performed in an operating room, generally in a hospital or other surgical facility.
Choose this code for the perineal approach when the operation is radical and the documented extent matches this code rather than a code that includes pelvic lymph node work. The operative report should identify the approach, the structures removed, and any nerve-sparing or lymph node procedures. CMS 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 procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires 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.
Where 55810 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $1,181.94 |
| Rest Of Oregon | Unavailable | $1,133.78 |
How the 55810 rate is calculated
Each of 55810’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 · 55810
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 23.68Practice expense 8.16Malpractice 3.04
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 55810
55810 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 55810
Radical prostatectomy
| 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) | 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. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 55810
Radical prostatectomy
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
55810 without 51 · national facility
$1,165.02
Radical prostatectomy
55810-51 · Second procedure: 50%
$582.51
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%).
55810 compared with similar codes
Compare codes
55810 vs 55840 vs 55812 vs 55815: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 55840Radical prostatectomy
- Both describe radical prostatectomy, but 55810 uses a perineal approach and 55840 uses a retropubic approach.
- 55812Radical prostatectomy
- This is a perineal radical prostatectomy sibling distinguished by lymph node work. Match the code to the documented extent of the operation.
- 55815Radical prostatectomy
- This sibling code describes perineal radical prostatectomy with a different extent of pelvic lymph node work; 55810 is for the operation without that added extent.
55810 billing questions
How does 55810 differ from 55840?
55810 is the perineal approach. 55840 is the retropubic approach to radical prostatectomy.
When should a code that includes lymph node work be used instead?
Use the applicable sibling code when pelvic lymph node biopsy or dissection is part of the operation. The operative report should support the extent of that work.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code because the descriptor or anatomy does not support modifier 50.
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?
An assistant at surgery may be paid. 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 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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