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55881 Ablt trurl prst8 tis thrm us

What 55881 is

CMS fee schedule short descriptor: Ablt trurl prst8 tis thrm us.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 55881 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)9.56266.751.24277.55$9,270.42
Facility (hospital, ASC)9.562.061.2412.86$429.54

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.


Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply (endoscopic or minor procedure: global period is the day of the procedure).

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Medically Unlikely Edit (MUE)

Medicare caps 55881 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 55881? These codes are bundled into it

55881 is a Column 1 code in 205 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
00910Anes transurethral px nos0 - no modifier bypassCheck pair
0213TNjx paravert w/us cer/thor0 - no modifier bypassCheck pair
0216TNjx paravert w/us lumb/sac0 - no modifier bypassCheck pair
0739TAbltj mal prst8 mag fld ndct0 - no modifier bypassCheck pair
12001Rpr s/n/ax/gen/trnk 2.5cm/<1 - modifier may bypassCheck pair
12002Rpr s/n/ax/gen/trnk2.6-7.5cm1 - modifier may bypassCheck pair
12004Rpr s/n/ax/gen/trk7.6-12.5cm1 - modifier may bypassCheck pair
12005Rpr s/n/a/gen/trk12.6-20.0cm1 - modifier may bypassCheck pair
12006Rpr s/n/a/gen/trk20.1-30.0cm1 - modifier may bypassCheck pair
12007Rpr s/n/ax/gen/trnk >30.0 cm1 - modifier may bypassCheck pair
12011Rpr f/e/e/n/l/m 2.5 cm/<1 - modifier may bypassCheck pair
12013Rpr f/e/e/n/l/m 2.6-5.0 cm1 - modifier may bypassCheck pair
12014Rpr f/e/e/n/l/m 5.1-7.5 cm1 - modifier may bypassCheck pair
12015Rpr f/e/e/n/l/m 7.6-12.5 cm1 - modifier may bypassCheck pair
12016Rpr fe/e/en/l/m 12.6-20.0 cm1 - modifier may bypassCheck pair
12017Rpr fe/e/en/l/m 20.1-30.0 cm1 - modifier may bypassCheck pair
12018Rpr f/e/e/n/l/m >30.0 cm1 - modifier may bypassCheck pair
12020Tx supfc wnd dehsn smpl clsr1 - modifier may bypassCheck pair
12021Tx supfc wnd dehsn w/packing1 - modifier may bypassCheck pair
12031Intmd rpr s/a/t/ext 2.5 cm/<1 - modifier may bypassCheck pair
12032Intmd rpr s/a/t/ext 2.6-7.51 - modifier may bypassCheck pair
12034Intmd rpr s/tr/ext 7.6-12.51 - modifier may bypassCheck pair
12035Intmd rpr s/a/t/ext 12.6-201 - modifier may bypassCheck pair
12036Intmd rpr s/a/t/ext 20.1-301 - modifier may bypassCheck pair
12037Intmd rpr s/tr/ext >30.0 cm1 - modifier may bypassCheck pair
12041Intmd rpr n-hf/genit 2.5cm/<1 - modifier may bypassCheck pair
12042Intmd rpr n-hf/genit2.6-7.51 - modifier may bypassCheck pair
12044Intmd rpr n-hf/genit7.6-12.51 - modifier may bypassCheck pair
12045Intmd rpr n-hf/genit12.6-201 - modifier may bypassCheck pair
12046Intmd rpr n-hf/genit20.1-301 - modifier may bypassCheck pair

Showing 30 of 205 column 2 codes. Use the pair checker for any specific combination.

55881 is bundled into these codes

55881 appears as a Column 2 code in 18 active edits. Reported with one of these Column 1 codes on the same date of service, 55881 is the code that denies.

Column 1 codeShort descriptionModifier indicator
0714TTpla b9 prst8 hyprplsa<50ml0Check pair
0738TTx pln mag fld abltj prst80Check pair
52648Laser surgery of prostate0Check pair
55801Removal of prostate0Check pair
55810Extensive prostate surgery0Check pair
55812Extensive prostate surgery0Check pair
55815Extensive prostate surgery0Check pair
55821Removal of prostate0Check pair
55831Removal of prostate0Check pair
55840Extensive prostate surgery0Check pair
55842Extensive prostate surgery0Check pair
55845Extensive prostate surgery0Check pair
55873Cryoablate prostate0Check pair
55880Abltj mal prst8 tiss hifu0Check pair
72195Mri pelvis w/o dye0Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.