CPT code 55881: Prostate ablation2026 Medicare rate & RVUs in Oregon
Reports transurethral thermal ultrasound ablation of prostate tissue, with imaging guidance included when performed, rather than transrectal HIFU or another ablation method.
Medicare pays $9,222.48–$10,253.90 for 55881 in the office in Oregon, from Rest Of Oregon to Portland. 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 55881 covers
A urologist delivers thermal ultrasound to prostate tissue through a transurethral device to ablate the targeted tissue. The procedure is typically performed in a hospital or ambulatory surgical setting; imaging guidance used during treatment is part of the service when performed. The operative record should identify the ablation method and document the treated prostate tissue and treatment session.
Report 55881 for the transurethral thermal ultrasound approach, not for transrectal HIFU or prostate removal. Imaging guidance performed as part of the ablation is included. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery for this code; 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.
Where 55881 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $10,253.90 | $431.68 |
| Rest Of Oregon | $9,222.48 | $416.96 |
How the 55881 rate is calculated
Each of 55881’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 · 55881
RVUs × geographic indexes × conversion factor
Work9.56
9.56 RVUs× 1.000 GPCI
Practice expense266.75
266.75 RVUs× 1.000 GPCI
Malpractice1.24
1.24 RVUs× 1.000 GPCI
Adjusted RVUs
277.5500
Conversion factor
$33.4009
Medicare rate
$9,270.42
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 55881
The CMS indicators that decide how 55881 is paid alongside other services.
CMS payment indicators · 55881
Prostate ablation
| 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| 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
55881 without 51 · national office
$9,270.42
Prostate ablation
55881-51 · Second procedure: 50%
$4,635.21
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%).
55881 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 55880Prostate HIFU
- Use 55881 for the transurethral thermal ultrasound approach. Code 55880 describes transrectal high-intensity focused ultrasound ablation.
- 55873Prostate cryoablation
- Code 55873 represents prostate cryoablation; 55881 uses thermal ultrasound delivered transurethrally.
- 55877Prostate ablation
- Code 55877 describes percutaneous irreversible electroporation. Select 55881 when the documented technique is transurethral thermal ultrasound.
55881 billing questions
How is 55881 different from 55880?
55881 describes transurethral thermal ultrasound ablation. Code 55880 is for prostate ablation using high-intensity focused ultrasound delivered transrectally.
Can imaging guidance be billed separately?
Imaging guidance performed as part of the transurethral thermal ultrasound ablation is included in 55881.
Should modifier 50 be appended for treatment on both sides?
No. Modifier 50 is inappropriate for this service; the code is not reported as a bilateral procedure.
Is an assistant at surgery payable?
No. Medicare's statutory restriction bars assistant-at-surgery payment for 55881.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full; other procedures in that session are subject to the standard multiple-procedure reduction.
What documentation supports reporting 55881?
Document the transurethral thermal ultrasound technique, the prostate tissue treated, and the procedure performed. The record should distinguish this approach from transrectal HIFU and other prostate ablation methods.
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
Fee sheets
Put 55881 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →