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See a sample rate comparisonCPT 55920 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.
General Surgery, Placement Of Needles Or Catheters Into Pelvic Organs And/Or Genitalia (Except Prostate) For Subsequent Interstitial Radioelement Application (Except Prostate) For Subsequent Interstitial Radioelement Application
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Reproductive System Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None AG - Primary physician UB |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 55920 |
| Medicaid Fee Schedule | View Medicaid rates for 55920 |
National average reimbursement for CPT 55920 by major payers:
$561.39
$595.76
$639.28
$756.49
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CPT 55920
5 of 25 sample ratesHigher to lower in this preview
Los Robles Surgicenter, LLC, Los Robles Surgicenter
Los Robles Surgicenter LLC
$7,210.00Published ratePine Ridge Surgery Center, LLC
$3,201.00Published rateSurgery Center Of Athens LLC
$2,435.00Published rateSt Lukes Surgical Center Inc
$1,200.00Published rateWarren Gastro Endoscopy Ctr Inc
$847.00Published rate
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See a sample payer proposalCPT 55920 vs. Other Reproductive System Procedures Codes
The CPT 55920 code is part of the Surgery services used for Reproductive System Procedures. 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 55920 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 |
|---|---|---|
| 55866-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). |
| 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. |
| 55920-CPT | Moderate | General Surgery, Placement Of Needles Or Catheters Into Pelvic Organs And/Or Genitalia (Except Prostate) For Subsequent Interstitial Radioelement Application (Except Prostate) For Subsequent Interstitial Radioelement Application |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 55920. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 55920 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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