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CPT 55876: Prostate Marker or Dosimetry Device Placement for Radiotherapy
CPT code 55876 identifies the image-guided placement of one or more location markers or a dosimetry device into the prostate using a needle before radiation therapy. This preparatory interventional procedure supports precise targeting and dose measurement during prostate radiotherapy and is a critical step in many definitive and adjuvant radiation treatment plans. Nationally, accurate coding for this procedure affects billing, facility classification, and quality tracking for prostate cancer care pathways.
Payers discussed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical purpose and service setting for the code, an overview of common modifiers and billing considerations, and benchmarks for payment and utilization where available. The publication also summarizes policy updates and payer-specific coverage patterns relevant to imaging-guided prostate marker placement, and highlights documentation elements that typically appear in medical records for claims support.
This summary provides clinicians, coding professionals, and payers with the procedural context and coding facts needed to align clinical documentation with billing practice for CPT code 55876 and to inform administrative and reimbursement workflows at a national level.
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Billing Code Overview
CPT code 55876 describes placement of one or more location markers or a device that measures radiation dosage within tissue gaps in the prostate prior to radiotherapy. The provider inserts the markers or dosimetry device into the prostate via a needle to guide or quantify subsequent radiation treatment.
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Service type: Implantation of prostate fiducial markers / dosimetry device for radiotherapy planning and delivery
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Typical site of service: Outpatient hospital or ambulatory surgical center; procedure performed in an interventional radiology or urology procedure suite