$227.72
Use 55707 when ultrasound guides a transrectal biopsy. Use 55705 when the biopsy is performed without imaging guidance.
On this page
CMS RVU26D · Effective 2026-10-01
55707 Prostate biopsy Medicare reimbursement rates in Vermont
Reports needle sampling of prostate tissue through the rectum with ultrasound guidance, commonly during evaluation of an elevated PSA or abnormal examination. Compare 55707 office and facility rates across CMS payment localities in Vermont.
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 55707 in Vermont?
Vermont 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
$333.83
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
Facility setting
$130.13
1 of 1 localities have a supported rate.
Payment area: Vermont
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 55707: Transrectal ultrasound-guided prostate biopsy
Reports needle sampling of prostate tissue through the rectum with ultrasound guidance, commonly during evaluation of an elevated PSA or abnormal examination.
A urologist typically uses a transrectal ultrasound probe to visualize the prostate and guide a needle that collects tissue cores. The procedure is commonly performed in an office or outpatient setting when prostate cancer is suspected, such as after an elevated prostate-specific antigen result or an abnormal digital rectal examination. The ultrasound-guided transrectal approach distinguishes this service from biopsies performed without imaging, by another route, or with MRI fusion.
Select the code when the documented biopsy uses the transrectal route and ultrasound guidance; the procedure note should support the approach and imaging method. The 0-day global period includes same-day preoperative and postoperative care. If other procedures are performed 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. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 55707
- 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 RVU2.63 · 26%
- Practice expense (office) RVU7.26 · 71%
- Malpractice RVU0.35 · 3%
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.
55707 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
55706 identifies transrectal saturation sampling. 55707 is selected for a transrectal biopsy guided by ultrasound when saturation sampling is not the defining method.
$409.50
55708 is the transrectal ultrasound-guided option with MRI fusion. Report 55707 for ultrasound-guided transrectal sampling without MRI fusion.
$570.31
Both involve ultrasound guidance, but 55709 uses the transperineal route; 55707 uses the transrectal route.
Compare 55707 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
Vermont →
Office / nonfacility
$333.83
Facility
$130.13
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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 55707 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
6,363
- Code
- 55707
- Physician work
- 2.63
- Practice expense
- 7.26
- Malpractice
- 0.35
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.63 | × 1.000 | 2.6300 |
| Practice expense | 7.26 | × 0.990 | 7.1874 |
| Malpractice | 0.35 | × 0.506 | 0.1771 |
| Total RVUs | 9.9945 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$333.83
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.63 | 1 |
| Practice expense | 7.26 | 0.99 |
| Malpractice | 0.35 | 0.506 |
(2.63 × 1 + 7.26 × 0.99 + 0.35 × 0.506) × $33.4009 = $333.83
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.63 | 1 |
| Practice expense | 1.1 | 0.99 |
| Malpractice | 0.35 | 0.506 |
(2.63 × 1 + 1.1 × 0.99 + 0.35 × 0.506) × $33.4009 = $130.13
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.
55707 billing questions
How does this differ from 55705?
55707 describes a transrectal biopsy performed with ultrasound guidance. Use 55705 when the biopsy is performed without imaging guidance.
When is 55706 a better fit?
55706 identifies transrectal needle sampling using a saturation technique. Choose based on the documented sampling method, rather than treating it as a routine ultrasound-guided biopsy.
Does MRI fusion change the code choice?
Yes. Code 55708 is the related transrectal ultrasound-guided biopsy option with MRI fusion; 55707 describes ultrasound guidance without that fusion distinction.
Can modifier 50 be reported for biopsies of both sides?
No. Modifier 50 is inappropriate for this code. The CMS bilateral adjustment does not apply.
What same-day care is included in the global period?
The 0-day global period includes same-day preoperative and postoperative care. Procedures performed in the same session are subject to the standard multiple-procedure payment reduction.
When can an assistant at surgery be paid?
Assistant-at-surgery payment is allowed only when the record documents medical necessity. 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 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.
6,36055680,,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
6,36655710,,Bx prst8 tprn us w/mri fus 1,A,,3.81,15.24,,1.35,,0.48,19.53,5.64,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817