Billing code 55920: Needle placementMedicare rate & RVUs in Utah
Reports surgical placement of needles or catheters in pelvic organs or genital structures to prepare for interstitial radiation source application.
CMS doesn’t publish an office rate for 55920 in Utah.
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 55920 covers
This service places needles or catheters in pelvic organs or genital structures in preparation for interstitial radiation. Target areas can include vaginal, perineal, urethral, or rectal tissue. A surgeon performs the placement, commonly a gynecologic oncologist or urologist depending on the anatomy and treatment plan, often in an operating room. The radiation oncologist coordinates the planned source application; placement itself is not radiation delivery.
Choose the code when the documented work is pelvic needle or catheter placement for subsequent interstitial treatment, rather than an intracavitary applicator or a prostate-specific placement. The operative report should identify the target anatomy, placement performed, and connection to the planned radiation treatment. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. 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. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; 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.
55920 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $376.33 |
How the 55920 rate is calculated
Each of 55920’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 · 55920
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.10Practice expense 2.71Malpractice 0.69
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 55920
The CMS indicators that decide how 55920 is paid alongside other services.
CMS payment indicators · 55920
Needle placement
| 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) | 0 | Not paid without supporting documentation. |
| 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
55920 without 51 · national facility
$384.11
Needle placement
55920-51 · Second procedure: 50%
$192.06
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%).
55920 compared with similar codes
Compare codes
55920 vs 55875 vs 57155 vs 77778: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 55875Prostate brachytherapy
- 55875 is specific to transperineal placement into the prostate. Use 55920 for the pelvic-organ or genital targets described by this code.
- 57155Brachytherapy applicator
- 57155 concerns intracavitary placement of a uterine or vaginal applicator. 55920 describes interstitial needle or catheter placement in pelvic tissue.
- 77778Interstitial brachytherapy
- 77778 describes complex interstitial radiation source application, while 55920 concerns pelvic needle or catheter placement. Review the documented work and code instructions before reporting both.
55920 billing questions
How does 55920 differ from prostate needle placement?
Use 55920 for the described pelvic-organ or genital placement for interstitial radiation. Code 55875 is the prostate-specific placement service.
Is this the radiation source application?
No. This code represents needle or catheter placement for subsequent interstitial treatment, not delivery of the radioactive source.
When is modifier 50 appropriate?
It is not appropriate for 55920; CMS identifies bilateral adjustment as inapplicable to this code.
What documentation supports reporting 55920?
Document the pelvic target, the needle or catheter placement performed, and its purpose in the interstitial radiation plan.
Can an assistant-at-surgery be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted.
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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