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 |
| Medicare Fee Schedule | View Medicare rates for 55880 |
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 | $2308.00 | 1922526961 - BLAINE ASC, LLC, BLAINE ORTHOPEDIC SURGERY CENTER | 822416401 - (MN) BLAINE ASC LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $1001.00 | 1487059002 - RIVERWALK ASC, LLC, RIVERWALK ASC | 472075991 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $1000.00 | 1740230523 - SARASOTA AMBULATORY SURGERY CENTER LTD, SARASOTA AMBULATORY SURGERY CENTER | 203686491 - (FL) SARASOTA AMBULATORY SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $917.00 | 1851312771 - COLUMBUS ENDOSCOPY CENTER, INC | 640926861 - (MS) COLUMBUS ENDOSCOPY CENTER INC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $900.00 | 1346349164 - SOUTHERN ALABAMA SURGERY CENTER LLC, SURGERY CENTER SOUTH | 621827534 - (AL) SOUTHERN ALABAMA SURGERY CENTER, LL | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $2388.00 | 1235178146 - SUBURBAN ENDOSCOPY CENTER, LLC, SUBURBAN ENDOSCOPY CENTER | 820556996 - (NJ) SUBURBAN ENDOSCOPY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $2388.00 | 1265534556 - SOUTH FLORIDA AMBULATORY SURGICAL CENTER LLC | 651093026 - (FL) SOUTH FLORIDA AMBULATORY SURGI | FL | 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 | 55880 | $1207.00 | 1275516718 - PREMIER SURGICAL CENTER, INC | 200671644 - (ID) PREMIER SURGICAL CENTER INC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $967.00 | 1891754271 - WESTERN WASHINGTON ENDOSCOPY CENTERS LLC, DIGESTIVE HEALTH NETWORK ENDOSCOPY CENTER | 200289310 - (WA) WESTERN WASHINGTON ENDOSCOPY CENTERS LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $2188.00 | 1184686164 - SHORE AMBULATORY SURGICAL CENTER, LLC | 223778333 - (NJ) SHORE AMBULATORY SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $2388.00 | 1306575121 - ROCKY MOUNTAIN ENDOSCOPY CENTERS, LLC | 841403147 - (CO) ROCKY MOUNTAIN ENDOSCOPY CENTERS LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $2206.00 | 1770929044 - SURGCENTER OF PALM BEACH GARDENS, SURGCENTER OF PALM BEACH GARDENS, LLC | 462315994 - (FL) SURGCENTER OF PALM BEACH GARDENS, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $4304.00 | 1710931860 - GRASS VALLEY SURGERY CENTER, LLC | 272185264 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 55880 | $1001.00 | 1518920040 - COUNTRYSIDE SURGERY CENTER, LTD | 752400186 - (FL) COUNTRYSIDE SURGERY CENTER LTD | FL | 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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