$238.87
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.
On this page
CMS RVU26D · Effective 2026-10-01
55706 Prostate biopsy Medicare reimbursement rates in Rhode Island
Reports extensive needle sampling of the prostate to evaluate suspected cancer, including imaging guidance used during the saturation biopsy. Compare 55706 office and facility rates across CMS payment localities in Rhode Island.
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 55706 in Rhode Island?
Rhode Island 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
$205.68
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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.
Prostate procedures
About 55706: Prostate saturation needle biopsy
Reports extensive needle sampling of the prostate to evaluate suspected cancer, including imaging guidance used during the saturation biopsy.
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.
CMS billing rules for 55706
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 RVU4.16 · 68%
- Practice expense (office) RVU1.40 · 23%
- Malpractice RVU0.53 · 9%
7.1K
Medicare services in 2024 · #1650 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.
55706 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
$350.43
55707 is an ultrasound-guided biopsy through a transrectal approach. 55706 identifies saturation sampling rather than that specific approach.
$597.56
55709 identifies ultrasound-guided biopsy through a transperineal approach. 55706 is selected for saturation sampling, not solely because of the needle-entry route.
Compare 55706 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
Rhode Island →
Office / nonfacility
Unavailable
Facility
$205.68
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 55706 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
6,362
- Code
- 55706
- Physician work
- 4.16
- Practice expense
- 1.40
- Malpractice
- 0.53
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.16 | × 1.019 | 4.2390 |
| Practice expense | 1.40 | × 1.033 | 1.4462 |
| Malpractice | 0.53 | × 0.892 | 0.4728 |
| Total RVUs | 6.1580 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$205.68
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.16 | 1.019 |
| Practice expense | 1.4 | 1.033 |
| Malpractice | 0.53 | 0.892 |
(4.16 × 1.019 + 1.4 × 1.033 + 0.53 × 0.892) × $33.4009 = $205.68
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.
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 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.
6,35955650,,Remove sperm duct pouch,A,,12.33,5.59,NA,5.59,,1.59,19.51,19.51,0,090,0.10,0.80,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,36055680,,Remove sperm pouch lesion,A,,5.53,3.41,NA,3.41,,0.70,9.64,9.64,0,090,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,36155705,,Bx prst8 any approach nonimg,A,,1.88,4.87,,0.88,,0.23,6.98,2.99,0,000,0.00,0.00,0.00,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,36255706,,Bx prst8 ndl sat sampling,A,,4.16,1.40,NA,1.40,,0.53,6.09,6.09,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,36355707,,Bx prst8 trct us guided,A,,2.63,7.26,,1.10,,0.35,10.24,4.08,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,36455708,,Bx prst8 trct us w/mri fus 1,A,,3.39,8.74,,1.26,,0.43,12.56,5.08,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,36555709,,Bx prst8 tprnl us guided,A,,3.23,13.77,,1.23,,0.42,17.42,4.88,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537