CPT code 55709 denotes a transperineal ultrasound-guided prostate biopsy in which the clinician collects cores from standard mapped sextants and any sonographically identified lesions. This procedure is a key diagnostic tool for detecting prostate cancer and guiding subsequent management decisions. Nationally, transperineal approaches have grown in relevance due to potential differences in infection risk and sampling patterns compared with transrectal techniques. Coverage and coding guidance for 55709 influences access to image-guided prostate biopsy across outpatient settings.

Key payers covered 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 delivery for 55709, a review of typical sites of service and operational considerations, and where available, payer coverage patterns and policy notes. The publication also summarizes benchmarks related to utilization and billing practice, and highlights relevant coding relationships and documentation elements that affect claim adjudication.

This executive summary is intended to inform clinicians, billing professionals, and policy analysts about the clinical purpose and billing context of CPT code 55709 at a national level, and to clarify what to expect when this procedure is reported in outpatient settings.