Billing code 55720: Abscess drainageMedicare rate & RVUs in Texas
Surgical drainage of a prostate abscess by a non-transurethral route, reported when the operative service opens and evacuates the infected collection.
CMS doesn’t publish an office rate for 55720 in Texas.
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 55720 covers
A urologist uses this service to drain an abscess within the prostate through a non-transurethral route. The operative approach is selected to reach and evacuate the infected collection; the procedure is generally performed in a surgical facility. It is therapeutic drainage, not a prostate biopsy for tissue diagnosis. The transurethral route is represented by a separate code.
Report 55720 when the operative record supports prostate abscess drainage and identifies a non-transurethral approach. Document the abscess, route, operative findings, and drainage performed. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be available; 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 55720 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $419.52 |
| Beaumont | Unavailable | $401.10 |
| Brazoria | Unavailable | $408.81 |
| Dallas | Unavailable | $412.27 |
| Fort Worth | Unavailable | $411.39 |
| Galveston | Unavailable | $410.64 |
| Houston | Unavailable | $428.58 |
| Rest Of Texas | Unavailable | $405.34 |
How the 55720 rate is calculated
Each of 55720’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 · 55720
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.54Practice expense 3.91Malpractice 0.98
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 55720
55720 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 55720
Abscess drainage
| 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 · 55720
Abscess drainage
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
55720 without 51 · national facility
$415.17
Abscess drainage
55720-51 · Second procedure: 50%
$207.59
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%).
55720 compared with similar codes
Compare codes
55720 vs 55725 vs 55705: national Medicare rates
Swap in your local Medicare rate.
How to choose
55720 billing questions
How do I choose between 55720 and 55725?
Use 55720 for prostate abscess drainage by a non-transurethral route. Use 55725 when the drainage is performed transurethrally.
Is this a prostate biopsy code?
No. It reports therapeutic drainage of an abscess. Prostate biopsy codes describe tissue sampling for diagnosis.
What should the operative note document?
Document the prostate abscess, the approach used, operative findings, and the drainage performed. The approach is especially important in distinguishing 55720 from 55725.
Does the code include postoperative care?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days after surgery.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, with other procedures 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
Fee sheets
Put 55720 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 →