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    v1.0.30
    OpenPayerBilling CodesIncision Procedures on the ProstateCPT cpt-55715-targeted-prostate-biopsy-additional-lesion
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    CPT 55715: Additional Targeted Prostate Lesion Biopsy

    Medicare pays $83 on average nationally for this procedure.

    CPT code 55715 describes an add-on procedure for performing a biopsy of an additional targeted prostate lesion using MRI–ultrasound fusion or in‑bore CT/MRI guidance; the service type is image‑guided targeted prostate biopsy and the typical site of service is an ambulatory surgery center or hospital outpatient setting where MRI/CT fusion or in‑bore imaging guidance is available.

    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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    Clinical & Coding Specifications

    Clinical Context

    A 65-year-old male with a rising prostate-specific antigen (PSA) and a prior multiparametric prostate MRI demonstrating two suspicious lesions undergoes targeted prostate biopsy using MRI–ultrasound fusion guidance. The urologist performs the initial targeted biopsy of the highest-risk lesion followed by an additional targeted biopsy of the second lesion during the same session. The procedure is performed in an outpatient ambulatory surgery center or radiology suite under local anesthesia with or without conscious sedation. Pre-procedure steps include informed consent, review of MRI images, registration of MRI to real-time transrectal ultrasound for fusion guidance, and sterile preparation. Post-procedure steps include hemostasis, brief observation for urinary retention or bleeding, and pathology submission of labeled cores. Billing includes the primary targeted lesion biopsy code for the first lesion and add-on code 55715 for each additional targeted lesion beyond the first.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    55700Biopsy, prostate; needle or punch, single or multiple, any approachOften used for systematic transrectal ultrasound-guided prostate biopsy cores performed during the same session; represents non-targeted (systematic) cores.
    53999Unlisted procedure, male genital system (used variably)Occasionally used if a novel or uncommon image-guided approach lacks a specific code; documentation must justify use and support medical necessity.
    76942Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization), imaging supervision and interpretationReported when real-time ultrasound guidance is performed to localize and guide the biopsy needle; billed in conjunction when payer allows.
    77021Magnetic resonance guidance for needle placement (eg, breast, prostate), imaging supervision and interpretationReported when in-bore MRI guidance is used for targeted prostate biopsy; billed when applicable and supported by documentation.
    88305Level IV surgical pathology, gross and microscopic examinationCommonly reported by pathology for each prostate biopsy specimen submitted and analyzed.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    47Modifier -47 (“Anesthesia by Surgeon”) is appended to a surgical or procedural CPT code when the surgeon personally provides regional or general anesthesia for the procedure. Use of -47 indicates the…- Use modifier -47 when the surgeon personally provides regional or general anesthesia during the surgical procedure (i.e., the surgeon administers the anesthesia in addition to performing 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…
    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…
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    73Modifier 73 indicates a facility-level outpatient hospital or ASC procedure that was discontinued after the patient was prepared and taken to the procedure/operating room but before any anesthesia…- When to use: Apply CPT modifier 73 on the FACILITY (outpatient hospital or ASC) claim when the patient has been fully prepared and physically taken into the procedure/operating room but the…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    2080P0207X
    207K00000X
    208000000X
    363L00000X
    2084P0800X
    1710I1003X
    246W00000X
    261QM1103X

    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-55714-IMAGE-GUIDED-TARGETED-PROSTATE-BIOPSY-CT-MRI

    CPT 55714: CT or MRI-Guided Targeted Prostate 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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