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See a sample rate comparisonCPT 55875 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.
Inject X-Ray Dye In Prostate, Placement Of Needles Or Catheters (Thin Tubes) Into The Prostate. These Will Carry A Contrast Solution (Saline Dye) To Aid An Imaging Procedure.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Male Genital System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None 58 - Staged or related procedure during postoperative period SG - Scene to Hospital ESRD facility |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 55875 |
| Medicaid Fee Schedule | View Medicaid rates for 55875 |
National average reimbursement for CPT 55875 by major payers:
$980.93
$1,021.61
$1,104.70
$1,278.22
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CPT 55875
5 of 25 sample ratesHigher to lower in this preview
Hinsdale Surgical Center, LLC
$17,486.00Published rateLake George Surgery Center, LLC
$4,840.00Published rateCapital Region Ambulatory Surgery Center, L.L.C.
Capital Region Ambulatory Surgery Center LLC
$2,619.00Published rateSyracuse Asc, LLC, Specialty Surgery Center Of Cny
Specialty Surgery Center Of Cny
$1,626.00Published rateBarnet Dulaney Perkins Eye Center, PC, American Vision Partners
Barnet Dulaney Perkins Eye Center PLLC
$713.00Published rate
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See a sample payer proposalCPT 55875 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 55875 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 55875 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 |
|---|---|---|
| 55873-CPT | High | Prostate Surgery, Surgery Aided By Ultrasound (Image Made With Sound Waves) To Freeze The Prostate Gland. This Is A Minimally Invasive Procedure That Does Not Remove The Prostate Gland. |
| 55874-CPT | High | Transperineal Placement Of Bio, Transperineal Placement Of Biodegradable Materialperi-Prostatic Single Or Multiple Injection(S) Including Image Guidance When Performed Ainage Procedure If Performed With Open Cervical Pharyngogastrostomy Or Esophagogastrostomy (Ie Th |
| 55875-CPT | Moderate | Inject X-Ray Dye In Prostate, Placement Of Needles Or Catheters (Thin Tubes) Into The Prostate. These Will Carry A Contrast Solution (Saline Dye) To Aid An Imaging Procedure. |
| 55876-CPT | Low | Place Radiation Therapy Guide, Insertion Of One Or More Radiation Therapy Guidance Devices. The Devices Guide Regulate Or Deliver Radiation Therapy To A Specific Place Inside The Body. Insertion May Be Done By Puncturing The Skin Or During Surgery. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 55875. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 55875 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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