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    v1.0.30
    OpenPayerBilling CodesLaparoscopic Procedures on the ProstateCPT cpt-55867-laparoscopic-prostate-excision-partial
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    CPT 55867: Laparoscopic Partial Prostate Excision with Urethrotomy

    Medicare pays $962 on average nationally for this procedure.

    CPT code 55867 describes a laparoscopic partial excision of the prostate gland that includes a concurrent vasectomy, incision and enlargement of the urethra (urethrotomy/urethral dilation), and hemostatic measures; the service is a minimally invasive laparoscopic urologic surgical procedure often performed in an inpatient or outpatient hospital operating room and may involve robotic assistance.

    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 progressive lower urinary tract symptoms (urinary frequency, weak stream, incomplete emptying) and bladder outlet obstruction due to benign prostatic hyperplasia (BPH). Conservative therapies including alpha-blockers and 5-alpha-reductase inhibitors have failed or the prostate volume is large with persistent obstruction and recurrent urinary retention. Preoperative evaluation includes history and physical, urinalysis, PSA as indicated, transrectal or transabdominal imaging to estimate prostate size, and counseling on risks including bleeding, urinary incontinence, erectile dysfunction, and need for future interventions.

    The planned operation is a laparoscopic simple prostatectomy (open or robot-assisted) using a transperitoneal or extraperitoneal approach to excise obstructing transition-zone prostatic tissue. Intraoperatively the surgeon may perform a concurrent vasectomy if requested or indicated for sterilization, may incise and enlarge the urethra (meatotomy or internal urethrotomy) if distal urethral stenosis exists, and will use hemostatic measures (sutures, cautery, topical agents) to control blood loss. Typical workflow: preop anesthesia assessment; general anesthesia with patient in lithotomy or low lithotomy/steep Trendelenburg as appropriate; port placement and laparoscopic or robot docking; enucleation or excision of adenomatous tissue; control of bleeding; optional adjunct procedures (vasectomy, urethral incision); placement of urethral catheter and bladder irrigation if needed; PACU recovery and short inpatient observation given expected blood loss and need for catheter management.

    Typical site of service: hospital inpatient or hospital outpatient surgery center with laparoscopic/robotic capability.

    Procedure context: billed under 55867 for laparoscopic excision of prostate (simple prostatectomy), possibly with robotic assistance; may be bundled with or accompanied by related procedural codes depending on additional distinct procedures and payer rules.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    55866Prostatectomy, suprapubic, retropubic, or perineal (open) - simple prostatectomy (partial)Alternative open approach for large BPH when laparoscopy is not used; may be chosen if minimally invasive approach not feasible.
    55840Radical prostatectomy, retropubic, with or without nerve-sparingDifferent procedure for prostate cancer involving whole gland removal; not a simple prostatectomy but related in preop workup differentiating benign vs malignant disease.
    52601Transurethral resection of prostate (TURP)Endoscopic alternative to simple prostatectomy for smaller prostates or when less invasive therapy is indicated; may be performed before or instead of 55867.
    55250Vasectomy, bilateral or unilateralRepresents the vasectomy component when performed concurrently; if separately reportable per payer rules, bill with appropriate modifier.
    52210Cystourethroscopy, with or without ureteral catheterizationDiagnostic or intraoperative cystoscopy commonly performed before, during, or after prostate excision to inspect urinary tract and guide hemostasis.

    Related Modifiers

    13 rows

    ModifierDescriptionWhen to Use
    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…
    63Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due 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…
    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…
    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…
    74Modifier ‑74 indicates an outpatient hospital or ASC procedure that was discontinued after anesthesia was administered and after the procedure had begun. Use this modifier when anesthesia (local,…- Use modifier -74 when a procedure in an outpatient hospital or ASC setting is terminated after anesthesia has been administered and after the procedure has commenced (for example, after incision,…
    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…

    Showing 1–10 of 13

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208100000X
    208D00000X
    208U00000X
    2084P0800X
    207RC0000X
    2279P1004X
    390200000X
    3747P1801X

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    D50.9Iron deficiency anemia, unspecified
    D62Acute posthemorrhagic anemia
    E11.9Type 2 diabetes mellitus without complications
    E78.5Hyperlipidemia, unspecified
    I10Essential (primary) hypertension
    N40.0Benign prostatic hyperplasia without lower urinary tract symptoms
    N40.1Benign prostatic hyperplasia with lower urinary tract symptoms
    N40.2Nodular prostate without lower urinary tract symptoms
    N41.0Acute prostatitis
    N41.9Inflammatory disease of prostate, unspecified

    Showing 1–10 of 26

    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-55866-LAPAROSCOPIC-RADICAL-PROSTATECTOMY-RETROPUBIC

    CPT 55866: Laparoscopic Radical Prostatectomy

    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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    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    37220
    Vascular embolization, any method, for pelvic hemorrhage
    Used in rare cases for postoperative bleeding control; may be performed if bleeding persists despite surgical hemostasis.