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CPT 55865 — Extensive prostate surgery

CPT code 55865 (Extensive prostate surgery) carries 23.96 work RVUs under the CMS 2026 Medicare Physician Fee Schedule. Total RVUs are 35.66 in a non-facility setting and 35.66 in a facility setting, which at the 2026 conversion factor of $33.40 works out to $1,191.08 and $1,191.08 respectively.

23.96
Work RVU
35.66
Total RVU (non-facility)
$1,191.08
Medicare, non-facility
$1,191.08
Medicare, facility
Calculate your total wRVUs →

RVU breakdown for CPT 55865

ComponentRVUsWhat it covers
Work RVU23.96Physician time, skill, effort, and stress.
Practice expense RVU (non-facility)8.64Office overhead, staff, supplies.
Practice expense RVU (facility)0.0Overhead when performed in a hospital.
Malpractice RVU3.06Professional liability cost.
Total RVU (non-facility)35.66Work + non-facility PE + malpractice.
Total RVU (facility)35.66Work + facility PE + malpractice.

How Medicare payment is calculated

Medicare multiplies total RVUs by the annual conversion factor. For CPT 55865 in 2026:

SettingTotal RVUConversion factorNational payment
Non-facility35.66$33.40$1,191.08
Facility35.66$33.40$1,191.08

These are national amounts. Actual payment is adjusted by the Geographic Practice Cost Index for your locality — check yours with the GPCI lookup.

Billing rules for CPT 55865

Global period
90-day global — major surgery; 90 days of follow-up care included.
Multiple procedure reduction
Subject to the standard multiple-procedure reduction (100%/50%/50%…).
Bilateral surgery
RVUs already reflect the bilateral procedure; no further adjustment.
Assistant surgeon
Permitted.
Co-surgeon
Not permitted.
Team surgery
Not permitted unless documentation supports medical necessity.

Related codes

Codes in the same CMS family, with their work RVU values.

55810 · 23.68 wRVU55812 · 29.14 wRVU55815 · 32.13 wRVU55845 · 24.55 wRVU55866 · 21.9 wRVU55869 · 27.41 wRVU

Questions about CPT 55865

How many work RVUs is CPT 55865?

CPT 55865 is assigned 23.96 work RVUs in the CMS 2026 Medicare Physician Fee Schedule.

What does Medicare pay for CPT 55865?

At the 2026 national conversion factor of $33.40, CPT 55865 pays approximately $1,191.08 in a non-facility setting and $1,191.08 in a facility setting before geographic adjustment.

What is the global period for CPT 55865?

90-day global — major surgery; 90 days of follow-up care included.

RVU values reflect the CMS 2026 Medicare Physician Fee Schedule (conversion factor $33.40). Payment figures are national and unadjusted for geography. Verify against the official fee schedule before using for billing.