2025 CPT code 55876
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Male Genital System Surgery Feed
Placement of interstitial device(s) for radiation therapy guidance (e.g., fiducial markers, dosimeter), prostate (via needle, any approach), single or multiple.
Modifiers 26 (professional component), 59 (distinct procedural service), and others may be applicable depending on the circumstances of the procedure.
Medical necessity for 55876 is established when a patient requires radiation therapy for prostate cancer and the placement of fiducial markers or dosimeters is necessary to ensure accurate targeting and dosimetry. This is typically supported by imaging studies showing the extent and location of the tumor.
The physician performs a digital rectal exam, uses ultrasound guidance to direct a needle into the prostate, inserts the fiducial markers or dosimeter, removes the ultrasound probe, irrigates the area, checks for bleeding, removes instruments, and closes the incision (if any).
In simple words: The doctor inserts small markers or a radiation-measuring device into the prostate gland using a needle. This helps guide radiation treatment to precisely target the prostate cancer.
This procedure involves the percutaneous placement of one or more interstitial devices, such as fiducial markers (e.g., gold seeds) or dosimeters, within the prostate gland.The devices are inserted via a needle, typically under ultrasound guidance, to mark the target area for subsequent radiation therapy. The procedure may include a digital rectal examination, ultrasound guidance, needle insertion, device placement, irrigation, bleeding control, and instrument removal.
Example 1: A patient diagnosed with prostate cancer is scheduled for radiation therapy.The physician performs 55876 to place gold seed markers within the prostate to precisely target the radiation beam., A patient with recurrent prostate cancer after prior radiation therapy requires additional treatment. The physician uses 55876 to implant a dosimeter to monitor radiation dosage during brachytherapy., A patient with a large prostate gland undergoes 55876 for placement of multiple fiducial markers to ensure accurate targeting of radiation therapy during external beam radiotherapy.
* Detailed history and physical examination including relevant imaging studies (e.g., MRI, CT, or biopsy reports) showing the extent of the prostate cancer.* Documentation of the procedure performed, including the type and number of devices implanted, technique used (e.g., ultrasound-guided), and location of the implants.* Operative report with details on the procedure performed, including any complications or unexpected findings.* Post-operative notes documenting the patient's recovery and any complications.* Consent form signed by the patient for the procedure.
** The supply of the devices used in this procedure (e.g., gold seeds, dosimeters) should be reported separately using appropriate HCPCS codes.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- Payment Status: Active
- Modifier TC rule: Modifier TC (Technical Component) is not applicable to this code as it represents the entire procedure.
- Specialties:Urology, Radiation Oncology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center