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 |
| CMS | $367.46 Physician Fee Schedule |
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 | $867.00 | 1629517800 - NORTHWEST SURGERY CENTER, LLC | 813834496 - (CO) NORTHWEST SURGERY CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $705.00 | 1558380675 - THE SURGERY CENTER, HOWLAND, HUMILITY OF MARY HEALTH PARTNERS | 341823901 - (OH) THE SURGERY CENTER HOWLAND | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $536.00 | 1740529064 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $2480.00 | 1760412803 - MEMORIAL HERMANN SURGERY CENTER KATY LLP | 203360737 - (TX) MEMORIAL HERMANN SURGERY CENTER KATY LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $410.00 | 1083654636 - PLASTIC SURGERY SPECIALISTS, PC, NORTH ARUNDEL PLASTIC SURGERY SPECIALISTS | 521357688 - (MD) PLASTIC SURGERY SPECIALISTS, P.C. | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $1276.00 | 1043303894 - DOCTORS OUTPATIENT SURGERY CENTER OF JUPITER, LLC, LASER & SURGERY CENTER OF THE PALM BEACHES | 650953183 - (FL) DRS. OUTPATIENT SURGERY CENTER OF JUPITER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $3064.00 | 1831240928 - NEW GULF COAST SURGERY CENTER, LLC | 646010232 - (MS) GULFPORT SURGERY CLINIC, LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $1179.00 | 1215548524 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $1020.00 | 1871868422 - PARAMOUNT SURGERY CENTER, LLC, THE CENTER FOR SPECIALIZED SURGERY | 452232749 - (FL) PARAMOUNT SURGERY CENTER 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 | $1258.00 | 1871751859 - WESTMINSTER SURGERY CENTER | 262059600 - (MD) WESTMINSTER SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $670.30 | 1689061723 - OSCIRIAH PRESS | 350593390 - DEACONESS HOSPITAL INC | GA | Hospitalist Physician (208M00000X) |
United | 55706 | $1875.00 | 1447995311 - NEW ENGLAND BAPTIST SURGERY CENTER LLC | 874311329 - (MA) NEW ENGLAND BAPTIST SURGERY CENTER LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $650.00 | 1154322600 - TEXOMA OUTPATIENT SURGERY CENTER, INC. | 752597635 - (TX) TEXOMA OUTPATIENT SURGERY CENTER INC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55706 | $1258.00 | 1780128553 - CAROLINAS ENDOSCOPY CENTER LLC | 814599818 - CAROLINAS ENDOSCOPY CENTER LLC | NC | 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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