Summary & Overview
CPT 55810: Perineal Prostatectomy for Prostate Cancer
CPT code 55810 represents an open perineal prostatectomy performed to excise the prostate for treatment of prostate cancer. This surgical oncology procedure is clinically significant as a definitive local therapy option for select patients and influences hospital surgical volumes, perioperative resource use, and national surgical quality measurement. Payers commonly involved in coverage and reimbursement for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise clinical and billing overview of the procedure, context on typical settings of care, and what to expect in payer coverage considerations. The publication outlines common modifiers used with the code, typical sites of service and staffing taxonomies where available, and related billing considerations that affect claims adjudication. It also summarizes how the code fits into surgical oncology service lines and highlights areas where policy updates or payer guidance can materially affect authorization and payment workflows.
Data not available in the input for specific associated taxonomies, ICD-10 diagnoses, related codes, and payer-specific pricing or utilization benchmarks.
Billing Code Overview
CPT code 55810 describes a perineal prostatectomy performed to treat prostate cancer. In this procedure the provider excises the prostate through an incision in the perineum and removes nearby structures as needed to achieve complete oncologic resection and reduce risk of local spread.
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Service type: Surgical oncology procedure (open perineal prostatectomy)
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Typical site of service: Hospital operating room or ambulatory surgery center, with inpatient admission as clinically indicated
Clinical & Coding Specifications
Clinical Context
A typical patient is a 65-year-old man diagnosed with clinically localized prostate adenocarcinoma after elevated prostate-specific antigen (PSA) and confirmatory transrectal ultrasound–guided biopsy. He is counseled on curative treatment options and elects radical perineal prostatectomy for definitive removal of the prostate and seminal vesicles. Preoperative workflow includes informed consent, preoperative labs, cardiac risk assessment, anesthesia evaluation, bowel prep as indicated, and antibiotic prophylaxis. Intraoperative steps include general or regional anesthesia, perineal incision, excision of the prostate with removal of adjacent seminal vesicles and lymphatic tissue as appropriate, hemostasis, possible nerve-sparing technique when oncologically safe, placement of urethrovesical anastomosis, and wound closure. Postoperative care includes monitoring in PACU, pain management, urinary catheter management, DVT prophylaxis, early ambulation, pathology review of the specimen to guide adjuvant therapies, and discharge planning with follow-up for catheter removal and oncologic surveillance.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Not typically appended; use per payer rules when no modifier applies |
11 |