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CPT 55862: Perineal Prostate Access for Brachytherapy with Lymph Node Sampling
CPT code 55862 denotes a surgical perineal approach to the prostate used to facilitate placement of radioactive material (brachytherapy) for malignant prostate cancer and includes sampling of regional lymph nodes with tissue sent for laboratory analysis. This procedure is a component of definitive local therapy for prostate malignancy and is relevant for surgical oncology, radiation oncology coordination, and pathology billing nationally.
Key payers in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for the procedure, a description of typical sites of service (hospital OR or ambulatory surgical center), and an outline of common billing considerations tied to the service line. The publication highlights benchmarks and policy-relevant topics affecting authorization, bundling with radiation therapy services, and documentation needs for lymph node sampling and tissue submission. It also summarizes where to expect variation across payers and settings.
This summary provides a concise reference for revenue cycle managers, surgical and radiation oncology teams, and compliance staff seeking to understand how CPT code 55862 maps to clinical workflow, site-of-service patterns, and payer coverage considerations at a national level.
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Billing Code Overview
CPT code 55862 describes a surgical procedure in which the provider makes an incision in the perineum to access the prostate for placement of radioactive material (brachytherapy) to treat malignant prostate cancer. The procedure includes sampling of nearby lymph nodes with submission of those tissues to a laboratory for pathological analysis.
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Service type: Surgical prostate access with lymph node sampling and tissue submission for pathology
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Typical site of service: Hospital operating room or ambulatory surgical center