2025 CPT code 55875
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Male Genital System Surgery Feed
Transperineal placement of needles or catheters into the prostate for interstitial radioelement application, with or without cystoscopy.
Modifiers may be applicable depending on the circumstances. For example, modifier 26 is used when reporting the professional component only, whereas the technical component is billed separately by the facility (hospital or ASC). Modifier 59 may be used to indicate a distinct procedural service.
Medical necessity is established by a confirmed diagnosis of prostate cancer, with the placement of radioactive seeds being a clinically indicated treatment modality. The appropriateness of this specific procedure (needle/catheter placement) is determined by the clinician considering the patient's overall health and the characteristics of the tumor.
Urologist or oncologist.The procedure involves placing needles or catheters into the prostate. A cystoscopy may be performed concurrently, but billing is for needle/catheter placement only.The oncologist places the radioactive seeds in a separate procedure.
In simple words: This code covers a procedure where thin tubes or needles are placed into the prostate gland through a small cut in the area between the scrotum and anus to deliver radioactive seeds for prostate cancer treatment.A separate procedure inserts the seeds; this code only bills for placing the needles/tubes. If a camera is used to look inside the bladder and urethra (cystoscopy) at the same time, there is no separate bill for that part.
This CPT code encompasses the transperineal placement of needles or catheters into the prostate gland to facilitate the subsequent application of interstitial radioactive elements for the treatment of prostate cancer.The procedure may or may not include a concurrent cystoscopy; if performed, the cystoscopy is considered inclusive and should not be billed separately.The placement of the radioactive seeds themselves is a separate procedure and is billed under different codes (e.g., 77770-77772, 77778). This code only covers the insertion of the needles or catheters.
Example 1: A 65-year-old male patient with prostate cancer is scheduled for transperineal brachytherapy. The urologist performs CPT 55875, placing needles into the prostate under ultrasound guidance. A separate procedure (77770-77772 or 77778) is performed by an oncologist for the placement of the radioactive seeds., A 70-year-old male patient presents with locally advanced prostate cancer.The urologist performs a cystoscopy and transperineal placement of catheters (CPT 55875). The cystoscopy is bundled into CPT 55875.Subsequently, the radiation oncologist implants the radioactive seeds (separate procedure)., A 62-year-old male patient with low-risk prostate cancer undergoes transperineal placement of needles (CPT 55875). The procedure is performed without a concurrent cystoscopy.The radioactive seeds are then placed by a radiation oncologist (a separate procedure and billing).
Detailed operative report documenting the transperineal approach, the number of needles/catheters placed, the depth of placement, and confirmation of prostate placement. If a cystoscopy was performed, this should also be documented.Pre-operative imaging (e.g., MRI, CT scan) should be noted. Pathology reports confirming the diagnosis of prostate cancer.
** This procedure is typically part of a larger brachytherapy protocol.Accurate documentation is crucial for proper billing and reimbursement.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: Data not available in source. Refer to CMS for current RVU values.
- Global Days: Data not provided in the source.Refer to the iFrameAI product for global period information.
- Payment Status: Active
- Modifier TC rule: Modifier 26 (professional component) and TC (technical component) modifiers are commonly used. The professional component is billed by the physician, while the technical component is billed by the facility.
- Fee Schedule: Data not available in source. Refer to CMS for historical fee schedules.
- Specialties:Urology, Oncology (Radiation Oncology)
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center