$725.67
Both are in-bore CT or MRI-guided prostate biopsy codes. Distinguish them by the specific service represented in the operative documentation and the applicable code descriptor.
On this page
CMS RVU26D · Effective 2026-10-01
55714 Prostate biopsy Medicare reimbursement rates in Utah
Reports prostate tissue sampling performed with the patient in a CT or MRI scanner, using in-bore imaging guidance to target a lesion. Compare 55714 office and facility rates across CMS payment localities in Utah.
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 55714 in Utah?
Utah 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
$707.39
1 of 1 localities have a supported rate.
Payment area: Utah
One mapped payment locality.
Facility setting
$165.48
1 of 1 localities have a supported rate.
Payment area: Utah
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.
Urology procedure
About 55714: In-bore image-guided prostate biopsy
Reports prostate tissue sampling performed with the patient in a CT or MRI scanner, using in-bore imaging guidance to target a lesion.
This service covers prostate tissue sampling performed with the patient in the CT or MRI scanner while imaging guides the biopsy needle to a targeted lesion. Urologists typically perform it in a hospital or other setting equipped for in-bore imaging and image-guided needle placement. It differs from MRI-ultrasound fusion biopsy, which uses ultrasound during sampling and combines it with previously acquired MRI information.
Report the code when the biopsy is performed using in-bore CT or MRI guidance; the operative report should identify the imaging method, targeted lesion, and tissue sampling performed. The service 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 other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 55714
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.62 · 16%
- Practice expense (office) RVU18.24 · 82%
- Malpractice RVU0.46 · 2%
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.
55714 compared with similar codes
Office rates for Utah, from the same CMS release.
$78.20
55715 is for additional-lesion sampling with MRI-ultrasound fusion or CT/MRI guidance; this code represents the in-bore biopsy service rather than the additional-lesion add-on.
$350.10
Use 55711 for transrectal MRI-ultrasound fusion guidance. This code describes biopsy performed in-bore under CT or MRI guidance.
Compare 55714 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
Utah →
Office / nonfacility
$707.39
Facility
$165.48
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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 55714 in Utah.
PPRRVU2026_Oct_nonQPP.csv
6,370
- Code
- 55714
- Physician work
- 3.62
- Practice expense
- 18.24
- Malpractice
- 0.46
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.62 | × 1.000 | 3.6200 |
| Practice expense | 18.24 | × 0.940 | 17.1456 |
| Malpractice | 0.46 | × 0.898 | 0.4131 |
| Total RVUs | 21.1787 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Utah$707.39
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.62 | 1 |
| Practice expense | 18.24 | 0.94 |
| Malpractice | 0.46 | 0.898 |
(3.62 × 1 + 18.24 × 0.94 + 0.46 × 0.898) × $33.4009 = $707.39
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.62 | 1 |
| Practice expense | 0.98 | 0.94 |
| Malpractice | 0.46 | 0.898 |
(3.62 × 1 + 0.98 × 0.94 + 0.46 × 0.898) × $33.4009 = $165.48
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.
55714 billing questions
How is this different from MRI-ultrasound fusion biopsy?
This code is for biopsy performed in-bore under CT or MRI guidance. MRI-ultrasound fusion biopsy uses ultrasound during sampling with MRI information fused for targeting.
What documentation supports reporting this code?
Document that sampling was performed with the patient in the CT or MRI scanner, the imaging modality used for guidance, and the targeted lesion and biopsy performed.
Is same-day postoperative care separately reported?
Same-day preoperative and postoperative care is included in the service's 0-day global period.
Can modifier 50 be used?
No. Bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are 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 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.
6,36755711,,Bx prst8 trct mri-us 1st,A,,2.61,8.04,,1.10,,0.35,11.00,4.06,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,36855712,,Bx prst8 tprnl mri-us 1st,A,,3.10,14.66,,1.22,,0.41,18.17,4.73,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,36955713,,Bx prst8 in-bore ct/mri bx 1,A,,4.00,18.38,,1.06,,0.50,22.88,5.56,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,37055714,,Bx prst8 in-bore ct/mri 1,A,,3.62,18.24,,0.98,,0.46,22.32,5.06,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,37155715,,Bx prst8 ea add mri-us/ct/mr,A,,1.05,1.24,,0.22,,0.14,2.43,1.41,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,37255720,,Drainage of prostate abscess,A,,7.54,3.91,NA,3.91,,0.98,12.43,12.43,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,37355725,,Drainage of prostate abscess,A,,9.80,5.30,NA,5.30,,1.27,16.37,16.37,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985