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See a sample rate comparisonCPT 55840 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Surgery To Remove Prostate, Surgery To Remove The Entire Prostate Gland Along With The Seminal Vesicles. The Procedure May Include Removing Lymph Nodes In The Groin Or Abdomen Or Taking A Sample Of Tissue For Testing (Biopsy).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Male Genital System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 51 - Multiple procedures GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 55840 |
| Medicaid Fee Schedule | View Medicaid rates for 55840 |
National average reimbursement for CPT 55840 by major payers:
$1,549.23
$1,642.37
$1,721.77
$1,967.23
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CPT 55840
5 of 25 sample ratesHigher to lower in this preview
Methodist Healthcare System Of San Antonio, Ltd., L.L.P., Methodist Hospital
$6,310.00Published rateCorpus Christi Surgicare Ltd, Christus Spohn Texas Orthopedic Center Of Excellence
Corpus Christi Surgicare Ltd
$1,274.00Published rateFlorida Eye Clinic Ambulatory Surgery Center, Inc.
$626.00Published rateAbingdon Surgical Center PC
$450.00Published rateBryn Mawr Medical Specialists Association
$200.00Published rate
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See a sample payer proposalCPT 55840 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 55840 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 55840 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 |
|---|---|---|
| 55801-CPT | High | Prostatectomy Perineal Subto, Prostatectomy Perineal Subtotal (Including Control Ofpostoperative Bleeding Vasectomy Meatotomyurethral Calibration Andor Dilation And Intern Al Urethrotomy) |
| 55815-CPT | High | Surgery To Remove Prostate, Surgery To Remove The Entire Prostate Gland Along With The Seminal Vesicles. The Procedure May Include Removing Lymph Nodes In The Groin Or Abdomen Or Taking A Sample Of Tissue For Testing (Biopsy). |
| 55821-CPT | High | Removal Of Prostate, Prostatectomy Including Control Of Postoperative Bleeding Vasectomy Meatotomy Urethral Calibration And Or Dilation And Internal Urethrotomy Suprapubic Subtotal 1 Or 2 Stages |
| 55840-CPT | High | Surgery To Remove Prostate, Surgery To Remove The Entire Prostate Gland Along With The Seminal Vesicles. The Procedure May Include Removing Lymph Nodes In The Groin Or Abdomen Or Taking A Sample Of Tissue For Testing (Biopsy). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 55840. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 55840 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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