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See a sample rate comparisonCPT 55725 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.
Prostatotomy Xtrnal Drain Of Prostatic Absces Any Approa; Co, Prostatotomy External Drainage Of Prostatic Abscess Any Approach; Co
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Male Genital System |
| Common Place of Service | 21 - Inpatient Hospital 11 - Office |
| Common Modifiers | None GC - Service performed by resident under supervision 58 - Staged or related procedure during postoperative period 59 - Distinct Procedural Service 51 - Multiple procedures 78 - Return to OR - related procedure |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 55725 |
| Medicaid Fee Schedule | View Medicaid rates for 55725 |
National average reimbursement for CPT 55725 by major payers:
$752.04
$789.74
$818.34
$974.89
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CPT 55725
5 of 25 sample ratesHigher to lower in this preview
West Penn Allegheny Health System Inc., Allegheny General Hospital
Highmark Health
$11,365.65Published ratePark Hill Surgery Center, LLC
Park Hill Surgery Center LLC
$4,141.00Published rateMedplex Outpatient Surgery Center Ltd, Medplex Outpatient Surgery Center
Medplex Outpatient Surgery Center Ltd
$2,388.00Published rateOlol Pontchartrain Surgery Center, LLC, Our Lady Of The Lake Pontchartrain Surgery Center
Olol Pontchartrain Surgery Cente
$1,563.00Published rateOrange County Ophthalmology Medical Group, Orange County Eye Surgical Center
Robert H. Collier, Md, Inc. Et Al, Ptr. Orange County Ophthalmology Me
$1,101.00Published rate
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See a sample payer proposalCPT 55725 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 55725 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 55725 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 |
|---|---|---|
| 55705-CPT | Moderate | Prostate Gland Biopsy, A Procedure To Remove A Sample Of Tissue From The Prostate Gland For Testing (Biopsy). The Sample May Be Taken In A Surgery Or With A Needle. |
| 55706-CPT | Moderate | Prostate Gland Biopsy, Prostate Gland Surgery To Remove A Sample Of Tissue For Testing (Biopsy). Stereotactic Imaging Precisely Maps The Target Location In 3-D. |
| 55720-CPT | Moderate | Prostatotomy Xtrnal Drain Of Prostatic Absces Any Approa; Si, Prostatotomy External Drainage Of Prostatic Abscess Any Approach; Si |
| 55725-CPT | Moderate | Prostatotomy Xtrnal Drain Of Prostatic Absces Any Approa; Co, Prostatotomy External Drainage Of Prostatic Abscess Any Approach; Co |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 55725. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 55725 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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