Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 53855 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Insert Device To Pass Urine, Insertion Of A Temporary Device To Hold Open The Urinary Tract (Stent). This Helps Urine Flow Past An Enlarged Prostate Gland.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Urinary System |
| Common Place of Service | 11 - Office 24 - Ambulatory Surgical Center |
| Common Modifiers | None 58 - Staged or related procedure during postoperative period 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 53855 |
| Medicaid Fee Schedule | View Medicaid rates for 53855 |
National average reimbursement for CPT 53855 by major payers:
$719.47
$953.83
$958.51
$1,133.75
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 53855.
CPT 53855
5 of 25 sample ratesHigher to lower in this preview
Centrum Surgery Center Ltd
$1,553.00Published rateNorthfield Surgical Center LLC, Northfield Surgical Center
Northfield Surgical Center LLC
$1,093.00Published ratePortsmouth Surgery Center
$629.00Published rateSkyline Surgery Center, LLC, Skyline Eye Surgery Center
Skyline Surgery Center LLC
$405.00Published rateCenter Of Surgical Excellence Of Venice Florida LLC
$239.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 53855 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 53855 code is part of the Surgery services used for Surgical Procedures on the Urinary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 53855 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 53850-CPT | High | Transurethr Destruct Of Prostat Tissue; By Microwav Thermothera, Transurethral Destruction Of Prostate Tissue; By Microwave Thermothera |
| 53852-CPT | High | Transurethr Destruct Of Prostat Tissue; By Radiofrequ Thermo, Transurethral Destruction Of Prostate Tissue; By Radiofrequency Thermo |
| 53854-CPT | High | Trurl Dstrj Prst8 Tiss Rf Wv, Destruction Of Prostate Tissue Accessed Through Urethra Using Radiofrequency Generated Water Vapor Heat Therapy |
| 53855-CPT | Moderate | Insert Device To Pass Urine, Insertion Of A Temporary Device To Hold Open The Urinary Tract (Stent). This Helps Urine Flow Past An Enlarged Prostate Gland. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 53855. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 53855 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 53855) and we'll show you how you compare in 15 minutes or less.