No office rate
Both codes address prostate abscess drainage. This code is specific to the transurethral route; 55720 is used for drainage by another approach.
On this page
CMS RVU26D · Effective 2026-10-01
55725 Abscess drainage Medicare reimbursement rates in Virginia
Reports operative drainage of a prostate abscess through a transurethral route, typically performed by a urologist in a surgical setting. Compare 55725 office and facility rates across CMS payment localities in Virginia.
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 55725 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$531.29–$600.75
2 of 2 localities have a supported rate.
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 surgery
About 55725: Transurethral prostate abscess drainage
Reports operative drainage of a prostate abscess through a transurethral route, typically performed by a urologist in a surgical setting.
A urologist uses a transurethral route to drain an abscess within the prostate. The procedure treats an established infection and collection; it is distinct from taking prostate tissue for cancer diagnosis. It is generally performed in a surgical setting when operative drainage is needed, with the operative report identifying the abscess and the route used to reach and drain it.
Report this code when the documented procedure is transurethral drainage, rather than drainage by another approach. The record should support the abscess diagnosis, operative findings, access route, and drainage performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 55725
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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 may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.80 · 60%
- Practice expense (office) RVU5.30 · 32%
- Malpractice RVU1.27 · 8%
17
Medicare services in 2024 · #6012 by national volume
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.
55725 compared with similar codes
Office rates for Virginia, from the same CMS release.
$228.11–$266.35
This code treats a prostate abscess by drainage. 55705 describes an incisional prostate biopsy for tissue diagnosis.
Compare 55725 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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$600.75
Virginia →
Office / nonfacility
Unavailable
Facility
$531.29
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55725 billing questions
How does this code differ from 55720?
Both codes describe drainage of a prostate abscess, but this code is for the transurethral approach. Use the code that matches the operative route documented.
Can a prostate biopsy code be reported for abscess drainage?
No. Biopsy codes describe obtaining prostate tissue for examination; this service describes operative drainage of an abscess.
How does the multiple-procedure reduction affect other procedures performed in the same session?
Medicare pays the highest-valued procedure in full and applies the standard 50% reduction to the other procedures in that session.
What documentation supports reporting this service?
Document the prostate abscess, the transurethral route, operative findings, and the drainage performed. The operative report should make the approach clear when distinguishing this code from 55720.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
6,37055714,,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
6,37455801,,Removal of prostate,A,,19.31,7.65,NA,7.65,,2.48,29.44,29.44,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,37555810,,Extensive prostate surgery,A,,23.68,8.16,NA,8.16,,3.04,34.88,34.88,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,37655812,,Extensive prostate surgery,A,,29.14,9.94,NA,9.94,,3.75,42.83,42.83,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00