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CPT 55700 Fee Schedule

Last Verified: November 2025

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.

Biopsy Prostate Needle/Punch
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Male Genital System

Common Place of Service

11 - Office

24 - Ambulatory Surgical Center

Common Modifiers

None

SG - Scene to Hospital ESRD facility

22 - Increased Procedural Services

Complexity LevelModerate
CMS$233.22 Physician Fee Schedule

National average reimbursement for CPT 55700 by major payers:

bcbs

$276.06

uhc

$314.96

aetna

$346.47

cigna

$398.29

Preview provider-level rates for...
For billing codeCPT 55700
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 55700

United
55700$1276.001326435926 - SELECT PHYSICIANS SURGERY CENTERS383935220 - (FL) SELECT PHYSICIANS SURGERY CENTER, LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
55700$1528.001013964063 - BRISTOL SURGERY CENTER, LLC834345983TNAmbulatory Surgical Clinic/Center (261QA1903X)
United
55700$670.001356890172 - DIALYSIS ACCESS SERVICES, LLC472322456 - (MD) DIALYSIS ACCESS SERVICES LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
55700$1025.001235692120 - LIBERTY CORNER SURGICAL CENTER AT MARLTON LLC833889870 - (NJ) LIBERTY CORNER SURGICAL CENTER AT MARLTON LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
55700$995.001760533830 - GASTROINTESTINAL MEDICAL CENTER ASC954373071CAAmbulatory Surgical Clinic/Center (261QA1903X)
United
55700$1258.001750565594 - PEDIATRIC SURGERY CENTER -ODESSA, LLC651274446FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
55700$449.001003858721 - PIEDMONT ENDOSCOPY CENTER, INC.561634105NCAmbulatory Surgical Clinic/Center (261QA1903X)
United
55700$728.001093716037 - CATARACT AND REFRACTIVE SURGERY CENTER, LLC, NOVAMED SURGERY CENTER OF RICHMOND, LLC621865972 - (VA) CATARACT AND REFRACTIVE SURGERY CENTER LLCVAAmbulatory Surgical Clinic/Center (261QA1903X)
United
55700$1276.001750363461 - BARKLEY SURGICENTER, LLC650428622 - (FL) BARKLEY SURGICENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
55700$2565.001326309394 - ADVANCED SURGERY CENTER OF ORLANDO LLC453785008 - (FL) ADVANCED SURGERY CENTER OF ORLANDO LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
55700$1579.001689666596 - MENOMONEE FALLS AMBULATORY SURGERY CENTER, LLC391745697 - (WI) MENOMONEE FALLS AMBULATORY SURGERY CENTERWIAmbulatory Surgical Clinic/Center (261QA1903X)
United
55700$330.001417534207 - MEDICAL CITY SURGERY CENTER OF FRISCO, LLC822432064 - (TX) MEDICAL CITY SURGERY CENTER OF FRISCO LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
55700$440.041023577848 - KHANG LAM350593390 - DEACONESS HOSPITAL INCINHospitalist Physician (208M00000X)
United
55700$5250.001275596264 - CAROLINA REGIONAL SURGERY CENTER. LTD621616402 - (SC) CAROLINA REGIONAL SURGERY CENTER LTDSCAmbulatory Surgical Clinic/Center (261QA1903X)
United
55700$1258.001912434697 - SUMMIT AMBULATORY SURGICAL CENTER, LLC522148280MDAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 55700 vs. Other Surgical Procedures on the Male Genital System Codes

The CPT 55700 code is part of the Surgery services used for Surgical Procedures on the Male Genital 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 55700 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.

CodeComplexityDescription
55650-CPTModerateVesiculectomy, Any Approach
55700-CPTModerateBiopsy Prostate Needle/Punch
55705-CPTModerateBx,Prostate;Incisional,Any Approach
55706-CPTModerateOnce Per Dos Biopsies, Prostate, Needle, Transperineal, Stereotactic Template Guided Saturation Sampling -Rn Review >=7/1/2018; Deny Inv/N10=5/8/2010-6/30/2018

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 55700. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 55700 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.

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