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    v1.0.30
    OpenPayerBilling CodesExcision Procedures on the ProstateCPT cpt-55815-perineal-prostatectomy-with-lymph-node-dissection
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    CPT 55815: Radical Perineal Prostatectomy with Lymph Node Dissection

    Medicare pays $1589 on average nationally for this procedure.

    CPT code 55815 describes a radical perineal prostatectomy for treatment of prostate cancer in which the surgeon excises the prostate through a perineal incision and performs removal of nearby structures and regional lymph nodes (external iliac, hypogastric, obturator) with specimens submitted for pathological analysis; service type: major surgical oncologic procedure; typical site of service: inpatient hospital operating room or ambulatory surgical center depending on patient status and perioperative requirements.

    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 68-year-old man with biopsy-proven, clinically localized prostate adenocarcinoma (e.g., Gleason score 7, rising PSA) is scheduled for a radical perineal prostatectomy with pelvic lymphadenectomy. He presents on the day of surgery after preoperative evaluation confirming fitness for general anesthesia. In the operating room, the urologic surgeon makes a perineal incision to excise the prostate gland, performs wide local excision of adjacent tissue as indicated by tumor extent, and removes regional lymph nodes (external iliac, hypogastric, obturator) for pathologic staging. Resected specimens are labeled and sent to the pathology laboratory for histologic assessment, margin evaluation, and nodal metastasis. Typical perioperative workflow includes preoperative consent and imaging review, intraoperative specimen handling, immediate postoperative recovery and pain control, and coordination of pathology results to guide further oncology management.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    55700Transurethral resection of prostate, including control of postoperative bleeding, completeMay be performed before or instead of definitive prostatectomy for obstructive symptoms; alternative endoscopic procedure.
    38571Biopsy or excision of lymph node(s); open, deep axillary node(s)Representative open lymph node procedure code; pelvic lymphadenectomy is more specific but lymph node excision and submission to pathology are integral to staging.
    88305Level IV surgical pathology, gross and microscopic examinationCommon pathology charge for prostate and nodal specimen evaluation submitted after prostatectomy.
    36415Collection of venous blood by venipunctureRoutine preoperative labs and postoperative monitoring.
    96372Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscularUsed for postoperative medications administered in clinic or recovery.

    Related Modifiers

    11 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    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…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Showing 1–10 of 11

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    163WC1500X
    204F00000X
    364SP0811X
    2084N0402X
    1835P1300X
    2251G0304X
    207LP3000X
    261QM1101X

    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-55801-PERINEAL-PROSTATECTOMY-FOR-OBSTRUCTIVE-PROSTATE-DISEASE

    CPT 55801: Radical Perineal Prostatectomy

    CPT-55810-PERINEAL-PROSTATECTOMY-FOR-PROSTATE-CANCER

    CPT 55810: Radical Perineal Prostatectomy

    CPT-55812-RADICAL-PERINEAL-PROSTATECTOMY

    CPT 55812: Radical Perineal Prostatectomy for Prostate Cancer

    CPT-55821-OPEN-PROSTATECTOMY-LOWER-ABDOMINAL-APPROACH

    CPT 55821: Retropubic Radical Prostatectomy with Urethral Incision

    CPT-55831-OPEN-PROSTATECTOMY-LOWER-ABDOMINAL-APPROACH

    CPT 55831: Retropubic Radical Prostatectomy, Open

    CPT-55840-RADICAL-RETROPUBIC-PROSTATECTOMY

    CPT 55840: Radical Prostatectomy, Retropubic Approach

    CPT-55842-RADICAL-PROSTATECTOMY-WITH-PELVIC-LYMPH-NODE-REMOVAL

    CPT 55842: Radical Prostatectomy with Pelvic Lymph Node Dissection

    CPT-55845-RADICAL-PROSTATECTOMY-WITH-PELVIC-LYMPH-NODE-DISSECTION

    CPT 55845: Radical Prostatectomy with Pelvic Lymph Node Dissection

    CPT-55860-PERINEAL-ACCESS-FOR-PROSTATE-BRACHYTHERAPY

    CPT 55860: Transperineal Prostate Access for Brachytherapy

    CPT-55862-PROSTATE-PERINEAL-ACCESS-BRACHYTHERAPY-LYMPH-NODE-SAMPLING

    CPT 55862: Perineal Prostate Access with Lymph Node Sampling

    Showing 1–10 of 11

    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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