Billing code 55876: Prostate markersMedicare rate & RVUs in Texas
Needle placement of prostate fiducial markers or dosimeters to support image localization during planned radiation treatment.
Medicare pays $142.89–$155.83 for 55876 in the office in Texas, from Beaumont to Austin. 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 55876 covers
This service places one or more small interstitial devices, such as fiducial markers or a dosimeter, in the prostate to help localize the gland during radiation treatment. A urologist or other qualified physician typically performs the needle-based procedure, often with imaging guidance, in an office or facility. The needle approach may vary; the purpose is radiation guidance rather than delivery of radioactive seeds or removal of prostate tissue.
Report one service for the marker-placement session; the code includes single or multiple devices. The record should identify the prostate as the target, the devices placed, and their radiation-guidance purpose. CMS assigns 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 other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this prostate service. Medicare does not pay an assistant at surgery; co-surgeon or team-surgery payment requires supporting documentation.
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 55876 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 payment localities
$142.89 to $155.83
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $155.83 | $91.87 |
| Beaumont | $142.89 | $87.87 |
| Brazoria | $149.56 | $89.65 |
| Dallas | $150.56 | $90.35 |
| Fort Worth | $149.76 | $90.15 |
| Galveston | $150.05 | $90.01 |
| Houston | $153.52 | $93.49 |
| Rest Of Texas | $146.18 | $88.80 |
How the 55876 rate is calculated
Each of 55876’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 · 55876
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.69Practice expense 2.65Malpractice 0.19
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 55876
The CMS indicators that decide how 55876 is paid alongside other services.
CMS payment indicators · 55876
Prostate markers
| 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) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 1 | Permitted with supporting documentation. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
55876 without 51 · national office
$151.31
Prostate markers
55876-51 · Second procedure: 50%
$75.66
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%).
55876 compared with similar codes
Compare codes
55876 vs 55875 vs 55874 vs 55873: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 55875Prostate brachytherapy
- Choose 55876 for prostate markers or a dosimeter used to guide radiation localization. Choose 55875 for needle or catheter placement for interstitial radioactive-element treatment.
- 55874Prostate spacer
- This code covers devices placed within the prostate for radiation guidance; 55874 covers biodegradable material placed around the prostate.
- 55873Prostate cryoablation
- 55876 places radiation-guidance devices. 55873 describes prostate cryoablation, an ablative treatment rather than marker placement.
55876 billing questions
Is this code for fiducial markers or brachytherapy seeds?
Use it for needle placement of prostate markers or a dosimeter to guide radiation localization. Brachytherapy needle or catheter placement is a different service, reported with 55875.
Does one code cover multiple markers?
Yes. The service includes placement of a single device or multiple devices during the session; the number of markers does not create additional units.
Can prostate spacer placement be reported at the same session?
Marker placement and biodegradable material placement around the prostate are distinct services and may occur during the same preparation encounter. Document each service performed.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this prostate service.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the other procedures are subject to a 50% reduction. Medicare does not pay an assistant at surgery; co-surgeon or team-surgery payment requires supporting documentation.
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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