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    v1.0.30
    OpenPayerBilling CodesIncision Procedures on the ProstateCPT cpt-55714-image-guided-targeted-prostate-biopsy-ct-mri
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    CPT 55714: CT or MRI-Guided Targeted Prostate Biopsy

    Medicare pays $776 on average nationally for this procedure.

    CPT code 55714 describes a targeted prostate biopsy performed with the patient inside a CT or MRI scanner, using real-time CT or MRI imaging to guide the biopsy needle directly to a specific lesion; this is an image-guided interventional procedure typically performed by a radiologist or urologist in an ambulatory surgery center or hospital imaging suite and is categorized as an image-guided prostate biopsy service.

    For related coverage guidance, see recent payer policy updates: Dental Anesthesia Services, Anesthesia Services for Interventional Pain Management Procedures in an Adult, General Anesthesia and Conscious Sedation Services.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 65-year-old man with a rising prostate-specific antigen (PSA) level and a suspicious lesion identified on prior multiparametric magnetic resonance imaging (mpMRI). He is referred to an interventional radiologist or urologist for image-guided targeted prostate biopsy. The clinical workflow begins with review of the mpMRI to localize the lesion(s). On the day of the procedure the patient is prepped and positioned inside the MRI or CT scanner. Conscious sedation or monitored anesthesia care is provided as appropriate. Real-time MRI or CT imaging is used to guide a transperineal or transrectal needle trajectory directly into the targeted lesion. Multiple cores are obtained from the targeted area, with additional systematic cores as determined by the clinician. Post-procedure imaging or ultrasound may be used to confirm needle position and assess immediate complications. The patient is observed for bleeding or urinary retention, given post-biopsy instructions including antibiotics and activity restrictions, and scheduled for follow-up to review pathology results and plan definitive management if clinically indicated.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    55700Biopsy, prostate; needle or punch, single or multiple, any approachRepresents conventional non-image-targeted prostate biopsy often performed as systematic sampling; may be performed in addition to targeted biopsy.

    76872 | Ultrasound, transrectal; prostate, including guidance for needle placement | Often used for transrectal guidance and fusion targeting; may be used before, during, or instead of CT/MRI guidance.

    72197 | Magnetic resonance (MR) imaging, pelvic, without contrast material followed by contrast material and further sequences; prostate protocol (e.g., multiparametric MRI) | Pre-procedure multiparametric MRI is commonly used to identify and localize targets for 55714.

    77012 | CT guidance for percutaneous needle placement | CT guidance codes apply when CT is used to guide percutaneous needle placement; may be reported for CT-guided prostate biopsy when payer allows.

    55706 | Biopsy, prostate, transperineal, single or multiple, with transrectal ultrasound guidance, when performed | Represents transperineal approach with ultrasound guidance; may be an alternative technique performed in the same clinical context.

    99152 | Moderate sedation services provided by the same physician performing the diagnostic or therapeutic service, initial 15 minutes | Sedation and anesthesia-related services that may be reported when moderate sedation is provided during the image-guided biopsy.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207P00000X
    208U00000X
    363L00000X
    207K00000X
    2081P2900X
    106H00000X
    251V00000X
    207RS0012X

    Related ICD-10-CM Codes

    24 rows

    ICD-10-CM CodeDescription
    C61Malignant neoplasm of prostate
    D07.5Carcinoma in situ of prostate
    D29.1Benign neoplasm of prostate
    N40.0Benign prostatic hyperplasia without lower urinary tract symptoms
    N40.1Benign prostatic hyperplasia with lower urinary tract symptoms
    N40.2Nodular prostate without lower urinary tract symptoms
    N41.0Acute prostatitis
    N41.1Chronic prostatitis
    N41.9Inflammatory disease of prostate, unspecified
    N43.3Hydrocele, unspecified

    Showing 1–10 of 24

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Dental Anesthesia ServicesProvidence Health Plan2026-10-01
    Anesthesia Services for Interventional Pain Management Procedures in an AdultCigna2026-09-15
    General Anesthesia and Conscious Sedation ServicesUnitedHealthcare2026-09-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Elective Inpatient Services (for Idaho Only)UnitedHealthcare2026-06-01
    Sites of Servicepriority health2026-06-01
    Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Servicesuniverahealthcare2026-05-21

    Related Codes

    CPT-55705-PROSTATE-BIOPSY-NON-IMAGE-GUIDED

    CPT 55705: Prostate Tissue Sampling, Non‑Imaging Guided

    CPT-55706-TEMPLATE-GUIDED-TRANSPERINEAL-PROSTATE-SATURATION-BIOPSY

    CPT 55706: Template-Guided Saturation Biopsy of Prostate

    CPT-55707-TRANSRECTAL-ULTRASOUND-GUIDED-PROSTATE-BIOPSY-SEXTANT

    CPT 55707: Transrectal Ultrasound-Guided Prostate Biopsy, Sextant and Targeted

    CPT-55708-PROSTATE-BIOPSY-TRANSRECTAL-US-FUSION-TARGETED-SEXTANT

    CPT 55708: Transrectal Ultrasound–Guided Prostate Biopsy with MRI Fusion

    CPT-55709-TRANSPERINEAL-ULTRASOUND-GUIDED-PROSTATE-BIOPSY

    CPT 55709: Perineal Ultrasound-Guided Prostate Biopsy

    CPT-55710-TRANSPERINEAL-ULTRASOUND-FUSION-PROSTATE-BIOPSY

    CPT 55710: Transperineal Ultrasound‑Guided Sextant and Fusion Prostate Biopsy

    CPT-55711-MRI-ULTRASOUND-FUSION-TARGETED-PROSTATE-BIOPSY-FIRST-LESION

    CPT 55711: Transrectal MRI–Ultrasound Fusion Targeted Prostate Biopsy, First Lesion

    CPT-55712-TRANSPERINEAL-MRI-ULTRASOUND-FUSION-BIOPSY-SINGLE-LESION

    CPT 55712: Transperineal MRI–Ultrasound Fusion Targeted Prostate Biopsy, First Lesion

    CPT-55713-IMAGE-GUIDED-PROSTATE-BIOPSY-SEXTANT-AND-TARGETED-LESION

    CPT 55713: Image-Guided Prostate Biopsy, Sextant and Targeted Sampling

    CPT-55715-TARGETED-PROSTATE-BIOPSY-ADDITIONAL-LESION

    CPT 55715: Additional Targeted Prostate Lesion Biopsy

    Showing 1–10 of 12

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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