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    v1.0.30
    OpenPayerBilling CodesLaparoscopic Procedures on the ProstateCPT cpt-55866-laparoscopic-radical-prostatectomy-retropubic
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    CPT 55866: Laparoscopic Radical Prostatectomy

    Medicare pays $1100 on average nationally for this procedure.

    CPT code 55866 describes a radical prostatectomy performed via a minimally invasive laparoscopic retropubic approach in which the entire prostate gland is removed, often for prostate cancer; nerve‑sparing techniques and robotic assistance may be used. Service type: surgical procedure — minimally invasive/laparoscopic radical prostatectomy. Typical site of service: hospital operating room or ambulatory surgery center for definitive oncologic surgery under general anesthesia.

    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 64-year-old man with biopsy-proven localized prostate adenocarcinoma elects definitive surgical management. Preoperative staging includes multiparametric pelvic MRI and bone scan showing disease confined to the prostate without distant metastasis. The patient undergoes a minimally invasive radical retropubic prostatectomy with possible nerve-sparing technique and robotic assistance for excision of the prostate, seminal vesicles, and appropriate pelvic lymph node sampling. Typical clinical workflow includes preoperative counseling, anesthesia evaluation, intraoperative urinary catheter placement, lymph node assessment, prostate removal via a laparoscopic retropubic approach (robot-assisted or pure laparoscopic), hemostasis, possible placement of surgical drains, and postoperative recovery with inpatient observation or same-day discharge depending on complexity and comorbidities. Pathology of the prostate and any lymph nodes is obtained for staging and adjuvant treatment planning.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    55866Radical retropubic prostatectomy, with or without nerve-sparing; includes removal of prostate and seminal vesicles; may be performed with robotic assistance.Primary procedure for removal of the prostate for malignancy.
    38510Biopsy or excision of lymph node(s); open, superficialUsed when a superficial pelvic lymph node biopsy is performed in conjunction with prostatectomy.
    38525Biopsy or excision of pelvic lymph node(s); single or multiple, unilateral or bilateralPerformed when pelvic lymphadenectomy or nodal sampling is done during prostatectomy for staging.
    52000Cystoscopy, diagnostic, with or without collection of urine sampleMay be performed preoperatively or intraoperatively to evaluate the bladder or urethra if indicated.
    49900Laparoscopy, surgical; unlisted procedure, abdomen, peritoneum and omentumUsed only when a specific laparoscopic procedure code is not available for atypical laparoscopic maneuvers during the case.
    55866-62Radical retropubic prostatectomy with two surgeonsExample of reporting when two surgeons share operative responsibility for complex cases.

    Related Modifiers

    13 rows

    ModifierDescriptionWhen to Use
    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…
    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…
    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…
    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…
    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…

    Showing 1–10 of 13

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208100000X
    363A00000X
    207R00000X
    261QP3300X
    2278P1006X
    225CA2500X
    247200000X
    207LH0002X

    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-55867-LAPAROSCOPIC-PROSTATE-EXCISION-PARTIAL

    CPT 55867: Laparoscopic Partial Prostate Excision with Urethrotomy

    CPT-55868-LAPAROSCOPIC-RETROPUBIC-RADICAL-PROSTATECTOMY-NERVE-SPARING

    CPT 55868: Laparoscopic Retropubic Radical Prostatectomy, Nerve‑Sparing

    CPT-55869-LAPAROSCOPIC-RADICAL-PROSTATECTOMY-BILATERAL-LYMPHADENECTOMY

    CPT 55869: Laparoscopic Radical Prostatectomy with Bilateral Pelvic Lymphadenectomy

    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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