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    OpenPayerBilling CodesExcision Procedures on the ProstateCPT cpt-55845-radical-prostatectomy-with-pelvic-lymph-node-dissection
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    CPT 55845: Radical Prostatectomy with Pelvic Lymph Node Dissection

    Medicare pays $1229 on average nationally for this procedure.

    CPT code 55845 describes a radical prostatectomy with removal of the prostate and surrounding tissues plus dissection of the external iliac, hypogastric, and obturator lymph nodes; the procedure may be performed with or without nerve-sparing. Service type: major surgical procedure, oncologic urologic surgery. Typical site of service: inpatient hospital operating room or ambulatory surgical center for definitive prostate cancer surgery and pelvic lymph node staging.

    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 male with biopsy-proven localized prostate adenocarcinoma, rising prostate-specific antigen (PSA), and imaging that suggests organ-confined disease or limited regional nodal involvement. The patient presents for definitive surgical management: radical prostatectomy with pelvic lymph node dissection. Preoperative workflow includes urology consultation, informed consent addressing nerve-sparing options, anesthesia evaluation, pre-op labs, and cross-sectional imaging (CT or MRI) to assess lymph nodes. Intraoperatively, the surgeon performs removal of the prostate and seminal vesicles and dissects the external iliac, hypogastric (internal iliac), and obturator lymph nodes; a nerve-sparing approach may be performed depending on tumor location and oncologic considerations. Postoperative care includes recovery from anesthesia, monitoring for bleeding, urinary catheter management, pain control, pathology review of the prostate and lymph nodes, and discharge planning with follow-up for oncologic management and functional recovery.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    55866Laparoscopic radical prostatectomy (simple/other approach)Alternative minimally invasive approach; may be performed instead of open 55845 depending on surgeon technique.
    38571Biopsy or excision of lymph node(s); open, superficialPerformed for isolated nodal sampling when limited nodes are removed separately from radical prostatectomy specimen.
    43235Laparoscopy, surgical, gastric or abdominal procedures (example for access)Represents laparoscopic access codes that may be used in minimally invasive approaches; adjunct to robotic/laparoscopic prostatectomy.
    55866Robotic-assisted prostatectomy (if documented as approach)Robotic-assisted techniques often billed with the appropriate radical prostatectomy code and robotic supply/assistant modifiers per payer policy.

    Related Modifiers

    10 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…
    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…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    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…
    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…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    2084P0800X
    207RH0000X
    207T00000X
    208VP0000X
    261QM1200X
    246Q00000X
    2083P0901X
    207VH0002X

    Related ICD-10-CM Codes

    27 rows

    ICD-10-CM CodeDescription
    C61Malignant neoplasm of prostate
    C79.11Secondary malignant neoplasm of bladder
    C79.2Secondary malignant neoplasm of skin
    C79.51Secondary malignant neoplasm of bone
    C79.89Secondary malignant neoplasm of other specified sites
    C79.9Secondary malignant neoplasm of unspecified site
    C80.1Malignant (primary) neoplasm, unspecified
    D07.4Carcinoma in situ of penis
    D07.5Carcinoma in situ of prostate
    D29.1Benign neoplasm of prostate

    Showing 1–10 of 27

    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-55815-PERINEAL-PROSTATECTOMY-WITH-LYMPH-NODE-DISSECTION

    CPT 55815: Radical Perineal Prostatectomy with Lymph Node Dissection

    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-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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