CPT 55880 Fee Schedule
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.
| 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 • GC - Service performed by resident under supervision • PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | High |
| CMS | $951.31 Physician Fee Schedule |
National average reimbursement for CPT 55880 by major payers:
$1,266.63
$1,365.58
$1,354.16
$1,647.74
| 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 55880 | ||||||
United | 55880 | $948.00 | 1750352324 - SUNRISE AMBULATORY SURGICAL CENTER LLC | 943363471 - (AZ) SUNRISE AMBULATORY SURGICAL CENT | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $3008.00 | 1275071789 - KADLEC REGIONAL MEDICAL CENTER | 910655392 - KADLEC REGIONAL MEDICAL CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $5402.00 | 1972570117 - METHODIST MEDICAL CENTER ASC LP, METHODIST AMBULATORY SURGERY CENTER MEDICAL CENTER | 731713543 - (TX) METHODIST MEDICAL CENTER ASC LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $2388.00 | 1558618116 - TAVARES SURGERY LLC | 300728155 - (FL) TAVARES SURGERY LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $1335.00 | 1588756621 - HIGHLINE SOUTH AMBULATORY SURGERY CENTER, LLC, HIGHLINE SOUTH AMBULATORY SURGERY CENTER | 205001199 - (CO) HIGHLINE SOUTH AMBULATORY SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $1387.00 | 1104465012 - EVERGREEN EYE CENTER, PLLC | 911628032 - (WA) EVERGREEN EYE CENTER, INC. P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $1278.00 | 1356429765 - ASC OF GEORGIA DERMATOLOGIC SURGERY, ASC OF BAUCOM & MINA DERM SURGERY | 550892029 - (GA) ASC OF GEORGIA DERMATOLOGIC SURGERY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $1919.00 | 1578610564 - HOLDINGS OF SPINECARE, LLC, SPINECARE LLP | 200950730 - (TX) HOLDINGS OF SPINECARE LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $2859.00 | 1205195716 - ADVANCED ENDOSCOPY AND PAIN CENTER LLC | 454651695 - (CA) ADVANCED ENDOSCOPY AND PAIN CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $1505.00 | 1275569121 - SOUTHWESTERN EYE CENTER LTD, SOUTHWESTERN EYE SURGICENTER-CASA GRANDE | 860423068 - SOUTHWESTERN EYE CENTER, LTD. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $837.00 | 1366412710 - MEREDYTH SURGERY CENTER, PC | 593793678 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $5357.00 | 1619995180 - MED CITY DALLAS OUTPATIENT SURGERY CENTER, L.P., MEDICAL CITY SURGERY CENTER/DALLAS | 201043104 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $1283.00 | 1558612762 - QUEENS BOULEVARD ASC LLC | 274614930 | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $2206.00 | 1437419660 - ADVANCED SURGERY CENTER OF METAIRIE LLC | 453386956 - (LA) ADVANCED SURGERY CENTER OF METAIRIE | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $2353.00 | 1154323988 - CENTRAL VIRGINIA SURGI-CENTER LP, SURGI-CENTER OF CENTRAL VIRGINIA | 752967162 - (VA) CENTRAL VIRGINIA SURGICENTER LP | VA | 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 55880 vs. Other Surgical Procedures on the Male Genital System Codes
The CPT 55880 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 55880 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 |
|---|---|---|
| 55870-CPT | Moderate | Electroejaculation |
| 55873-CPT | High | Cryosurgical Ablation Of The Prostate (Includes Ultrasonic Guidance For Interstitial Cryosurgical Probe Placement) |
| 55874-CPT | High | Transperineal Placement Of Biodegradable Material Peri-Prostatic Single Or Multiple Injection(S) Including Image Guidance When Performed |
| 55880-CPT | High | Ablation Of Malignant Prostate Tissue Transrectal With High Intensity-Focused Ultrasound (Hifu) Including Ultrasound Guidance |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 55880. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 55880 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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