$1,360.14
Choose 53855 for prostatic urethral stent placement; 53850 describes microwave treatment of prostate tissue.
On this page
CMS RVU26D · Effective 2026-10-01
53855 Urethral stent Medicare reimbursement rates in Wisconsin
Reports placement of a prostatic urethral stent to maintain urine flow through an obstructed prostate, commonly for men with benign prostatic enlargement. Compare 53855 office and facility rates across CMS payment localities in Wisconsin.
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 53855 in Wisconsin?
Wisconsin 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
$624.21
1 of 1 localities have a supported rate.
Payment area: Wisconsin
One mapped payment locality.
Facility setting
$66.48
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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 53855: Prostatic urethral stent insertion
Reports placement of a prostatic urethral stent to maintain urine flow through an obstructed prostate, commonly for men with benign prostatic enlargement.
A urologist places a stent through the urethra into the prostatic segment to help keep the passage open when prostate enlargement obstructs urine flow. The service is used for men with lower urinary tract obstruction related to benign prostatic enlargement; cystoscopic placement is typical. It differs from procedures that ablate or remove prostate tissue because the treatment is stent placement rather than tissue destruction.
Report the insertion when the stent is placed, and document the indication, the device and its location, and the placement procedure. The code has 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% 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 53855
- 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 RVU1.60 · 8%
- Practice expense (office) RVU17.77 · 91%
- Malpractice RVU0.21 · 1%
257
Medicare services in 2024 · #4118 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.
53855 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
$1,329.66
53852 represents radiofrequency needle treatment of prostate tissue, not stent insertion.
$3,244.75
53854 describes water-vapor radiofrequency destruction of prostate tissue; 53855 is for placing a stent in the prostatic urethra.
Compare 53855 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
Wisconsin →
Office / nonfacility
$624.21
Facility
$66.48
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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 53855 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
6,230
- Code
- 53855
- Physician work
- 1.60
- Practice expense
- 17.77
- Malpractice
- 0.21
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.60 | × 1.000 | 1.6000 |
| Practice expense | 17.77 | × 0.958 | 17.0237 |
| Malpractice | 0.21 | × 0.308 | 0.0647 |
| Total RVUs | 18.6883 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wisconsin$624.21
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.6 | 1 |
| Practice expense | 17.77 | 0.958 |
| Malpractice | 0.21 | 0.308 |
(1.6 × 1 + 17.77 × 0.958 + 0.21 × 0.308) × $33.4009 = $624.21
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.6 | 1 |
| Practice expense | 0.34 | 0.958 |
| Malpractice | 0.21 | 0.308 |
(1.6 × 1 + 0.34 × 0.958 + 0.21 × 0.308) × $33.4009 = $66.48
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.
53855 billing questions
How does this differ from prostate tissue treatment codes?
This code represents placement of a prostatic urethral stent to maintain an open channel. Codes such as 53850, 53852, and 53854 describe prostate tissue treatment methods instead.
What documentation supports the service?
Document the obstructive indication, the stent placed and its prostatic location, and the procedural details confirming insertion.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inapplicable because this is not a bilateral procedure.
Is same-day care included in the procedure?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
When is an assistant-at-surgery payable?
Only when medical necessity for the assistant is documented. Co-surgeons and team surgery are not permitted for this code.
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.
6,22753850,,Prostatic microwave thermotx,A,,5.28,36.78,,3.96,,0.67,42.73,9.91,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,22853852,,Prostatic rf thermotx,A,,5.78,35.28,,4.06,,0.75,41.81,10.59,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,22953854,,Trurl dstrj prst8 tiss rf wv,A,,5.78,95.13,,4.07,,0.75,101.66,10.60,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,23053855,,Insert prost urethral stent,A,,1.60,17.77,,0.34,,0.21,19.58,2.15,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,23153860,,Transurethral rf treatment,A,,3.87,67.25,,1.69,,0.48,71.60,6.04,0,090,0.08,0.83,0.09,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,23253865,,Cysto insj dev ischmc rmdlg,A,,3.02,89.00,,0.95,,0.39,92.41,4.36,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,23353866,,Cathj rmvl dev ischmc rmdlg,A,,1.44,2.73,,0.58,,0.19,4.36,2.21,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,