CPT 55706 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Male Genital System |
| Common Place of Service | • 24 - Ambulatory Surgical Center • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • SG - Scene to Hospital ESRD facility • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
National average reimbursement for CPT 55706 by major payers:
$505.63
$508.49
$539.18
$648.21
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 55706 | ||||||
United | 55706 | $500.00 | 1346233905 - AMBULATORY SURGERY CENTER AT INDIANA EYE CLINIC LLC | 352129461 - (IN) AMBULATORY SURGERY CENTER AT INDIANA EYE CLINIC LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $585.50 | 1275184293 - JOHNS HOPKINS SURGERY CENTERS SERIES, BEL AIR SURGERY CENTER | 208707724 - (MD) JOHNS HOPKINS SURGERY CENTER SERIES | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $1200.00 | 1740289024 - KOOTENAI OUTPATIENT SURGERY CNTR LLC, KOOTENAI OUTPATIENT SURGERY | 820523354 - (ID) KOOTENAI OUTPATIENT SURGERY | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $800.00 | 1356672919 - CPMSC ROSWELL, LLC | 271697405 - (GA) CPMSC ROSWELL LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $644.00 | 1114025608 - ELLICOTT CITY AMBULATORY SURGERY CENTER, LLLP, ELLICOTT CITY AMBULATORY SURGERY CENTER | 631213860 - (MD) ELLICOTT CITY AMBULATORY SURGERY CENTER LLLP | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $936.00 | 1558456459 - PORTLAND ENDOSCOPY CENTER | 10432678 - (ME) PORTLAND ENDOSCOPY CENTER | ME | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $632.00 | 1033292214 - PIKES PEAK ENDOSCOPY AND SURGERY CENTER, LLC | 841379009 - (CO) PIKES PEAK ENDOSCOPY AND SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $1528.00 | 1245711803 - SURGCENTER CLEARWATER, LLC, SURGCENTER DUNEDIN | 823682684 - (FL) SURGCENTER CLEARWATER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $2833.00 | 1922559327 - PHYSICIANS WEST EL PASO SURGERY CENTER, LLC | 843452204 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $1433.00 | 1922165901 - CENTER FOR COSMETIC AND RECONSTRUCTIVE SURGERY, THE ROBERT ZUBOWSKI CENTER FOR COSMETIC AND RECONSTRUCTIVE SURGERY | 200768828 - (NJ) CENTER FOR COSMETIC AND RECONSTRUCTIVE SURGERY | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $1449.00 | 1881375319 - MIDWEST SURGERY CENTER, LLC, MIDWEST SURGERY CENTER - EAGAN | 411537436 - (MN) MIDWEST SURGERY CENTER | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $553.00 | 1073026639 - MID CITY SPECIALTY CENTER, LLC | 822996794 - (LA) MID CITY SPECIALTY CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $1835.00 | 1336252402 - ADVANCED ENDOSCOPY CENTER LLC | 10719837 - (NY) ADVANCED ENDOSCOPY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $2272.00 | 1528438884 - MCLEAN AMBULATORY SURGERY, LLC | 474966649 - (VA) MCLEAN AMBULATORY SURGERY LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $1179.00 | 1215548524 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 55706 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 55706 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 55706 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 |
|---|---|---|
| 55700-CPT | Moderate | Biopsy Prostate Needle/Punch |
| 55705-CPT | Moderate | Bx,Prostate;Incisional,Any Approach |
| 55706-CPT | Moderate | Once 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 |
| 55720-CPT | Moderate | Prostatotomy W Drain Abscess Simpl |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 55706. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 55706 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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