Summary & Overview
CPT 55706: Template-Guided Transperineal Prostate Saturation Biopsy
CPT code 55706 captures a template-guided transperineal saturation biopsy of the prostate, a procedure that uses a stereotactic template and imaging guidance to obtain multiple grid-pattern tissue samples. This technique is important nationally as an option for systematic prostate sampling when transrectal approaches are inadequate or when extensive sampling is clinically indicated. It has implications for diagnostic accuracy, care pathways for suspected prostate cancer, and procedural resource use.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and service settings, payer coverage considerations, and benchmarking where available. The publication highlights coding details for proper claim submission and billing workflows, outlines typical sites of service and service type, and summarizes common modifiers associated with the procedure. Where input data is incomplete, the text notes that specific fields are not available.
This executive summary supports clinicians, practice managers, and billing professionals seeking a national-level understanding of how CPT code 55706 fits into prostate diagnostic pathways, payer interactions, and administrative workflows.
Billing Code Overview
CPT code 55706 describes a template-guided saturation biopsy of the prostate, in which the provider performs multiple needle biopsies of the prostate gland through the perineum using a stereotactic template system. Imaging guidance is included as part of the procedure. This technique enables taking numerous tissue samples in a grid-like pattern to evaluate for prostate cancer or other prostate abnormalities.
Service type: Template-guided transperineal prostate biopsy (saturation biopsy)
Typical site of service: Ambulatory surgical center or hospital outpatient department, with the procedure performed in a sterile procedure room or operating suite under appropriate anesthesia.
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with an elevated prostate-specific antigen (PSA) of 12 ng/mL and a prior negative transrectal ultrasound–guided biopsy is referred for further evaluation. Multiparametric MRI of the prostate demonstrates a suspicious lesion in the anterior transition zone and diffuse small suspicious foci. The provider recommends a template-guided saturation prostate biopsy to obtain systematic, grid-pattern sampling through the perineum using a stereotactic template with imaging guidance (ultrasound or MRI/ultrasound fusion).
The clinical workflow includes pre-procedure counseling and consent, review of prior imaging and laboratory results, review of anticoagulation status, bowel preparation as applicable, and prophylactic antibiotics per local protocol. On the day of service the patient is positioned in lithotomy. Local anesthesia or monitored anesthesia care/general anesthesia is administered per plan. The stereotactic grid template is secured to the perineum and imaging guidance is used to map grid coordinates. Multiple percutaneous needle cores are obtained in a systematic grid (saturation sampling). Hemostasis is confirmed, perineal dressings applied, and post-procedure monitoring completed. Pathology specimens are sent with location labeling. Typical site of service is an outpatient ambulatory surgery center or hospital outpatient department that provides minor operative procedures under monitored anesthesia or local anesthesia.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier (standard) |