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CPT 55880: Transrectal HIFU Ablation of Malignant Prostate Tissue

CPT code 55880 designates transrectal high intensity–focused ultrasound (HIFU) ablation of malignant prostate tissue under ultrasound guidance. The code captures a minimally invasive, image-guided oncologic procedure increasingly relevant as focal and organ-preserving prostate cancer treatments expand. Nationally, the procedure is notable for its role in surgical oncology and urology care pathways and for payers' varied coverage approaches as technologies evolve.

Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of how CPT code 55880 is used in clinical practice, typical sites of service, and the payers commonly involved in coverage decisions. The publication summarizes benchmarking metrics where available, highlights policy considerations and recent coverage trends, and provides clinical context about the procedure's intent and setting.

This summary is intended for clinical, coding, and payer policy audiences seeking a clear, national-level description of the service represented by CPT code 55880, plus guidance on where to look for payer-specific coverage details and benchmarking data. Data not available in the input is noted where applicable.

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Billing Code Overview

CPT code 55880 describes a procedure in which a provider uses a high intensity–focused ultrasound (HIFU) device inserted through the rectum to ablate malignant prostate tissue under ultrasound guidance. This is a targeted, image-guided oncologic procedure.

Service type: Image-guided ablative procedure for prostate malignancy
Typical site of service: Ambulatory surgical center or hospital outpatient setting where transrectal ultrasound-guided interventions are performed

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CPT 55880: Transrectal HIFU Ablation of Malignant Prostate Tissue

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Billing Code Overview

Service type: Image-guided ablative procedure for prostate malignancy
Typical site of service: Ambulatory surgical center or hospital outpatient setting where transrectal ultrasound-guided interventions are performed

Clinical & Coding Specifications

Clinical Context

A 69-year-old male with biopsy-proven localized prostate adenocarcinoma (Gleason 3+4), rising PSA despite prior active surveillance, is scheduled for focal high intensity–focused ultrasound treatment. The patient presents to an outpatient ambulatory surgical center or hospital-based operating room. Pre-procedure workflow includes informed consent, pre-op anesthesia evaluation (general or spinal anesthesia), ultrasound imaging for target localization, and transrectal insertion of the HIFU device. The provider uses real-time ultrasound guidance to deliver focused thermal energy to ablate malignant prostate tissue while monitoring surrounding structures. Post-procedure workflow includes recovery in PACU, immediate assessment for urinary retention and rectal bleeding, catheter placement as needed, discharge instructions, and scheduled follow-up with PSA testing and repeat imaging or biopsy as clinically indicated.

Coding Specifications

Modifier	Description	When to Use
`11`	Office or other outpatient visit for evaluation and management	When an unrelated E/M visit occurs on the same day as the procedure and is separately identifiable
`22`	Increased procedural services	When work required is substantially greater than typically required for `55880`
`52`	Reduced services	When the procedure is partially reduced or discontinued
`53`	Discontinued procedure	When the procedure is started but terminated due to extenuating circumstances
`62`	Two surgeons	When two surgeons work together as primary surgeons performing distinct portions
`66`	Surgical team	When a team approach is used with multiple qualified surgeons
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period	For an unplanned re-entry to address a complication
`79`	Unrelated procedure or service by the same physician during the postoperative period	When an unrelated procedure is performed during the global period
`LT`	Left side	When laterality is relevant and the procedure is performed on the left prostate lobe (if laterality reporting required)
`RT`	Right side	When laterality is relevant and the procedure is performed on the right prostate lobe (if laterality reporting required)
`QK`	Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals	When anesthesia direction meets criteria for concurrent cases

Taxonomy Code	Specialty	Notes
363A00000X	Urology	Most common specialty performing HIFU for prostate malignancy
207RH0000X	Radiology — Radiation Oncology	Specialists involved when HIFU integrated into multidisciplinary local tumor control
207L00000X	Diagnostic Radiology	Provides ultrasound imaging guidance and intra-procedural interpretation
363LF0000X	Female Urology	(Included for completeness though uncommon for prostate procedures)
208800000X	Anesthesiology	Provides general/regional anesthesia and perioperative management

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C61`	Malignant neoplasm of prostate	Primary indication for HIFU to ablate localized prostate cancer
`D40.0`	Neoplasm of uncertain behavior of prostate	Situations where focal therapy may be considered for atypical lesions
`N40.0`	Benign prostatic hyperplasia with lower urinary tract symptoms	Coexisting BPH may affect planning and peri-procedural urinary management
`R33.8`	Other retention of urine	Potential peri-procedural complication requiring catheterization
`R31.9`	Hematuria, unspecified	Symptom that can occur after prostate ablation and prompts evaluation

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`51701`	Insertion of temporary indwelling urethral catheter; simple (e.g., straight catheterization)	Often performed before or after HIFU for urinary drainage or retention management
`55866`	Laparoscopic radical prostatectomy	Alternative definitive surgical treatment for localized prostate cancer; may be considered in treatment planning
`76942`	Ultrasonic guidance for needle placement (e.g., diagnostic or therapeutic)	Represents ultrasound guidance procedures; intra-procedural ultrasound guidance is intrinsic to `55880`
`52000`	Cystourethroscopy, diagnostic, with or without collection of specimen(s) by brushing or washing	May be performed if hematuria or urethral concern arises peri-procedurally
`99223`	Initial hospital care, typically 70 minutes or more, per day, for the evaluation and management of a patient	Example of an E/M service that may be billed for hospital admissions related to complications

CPT 55870: Electroejaculation and Semen Collection for Assisted Reproduction

CPT-55873-PROSTATE-CRYOABLATION-ULTRASOUND-GUIDED

CPT 55873: Ultrasound-Guided Prostate Cryoablation

CPT-55874-PROSTATE-BIODEGRADABLE-SPACE-INJECTION-IMAGE-GUIDED

CPT 55874: Image-Guided Prostate Biodegradable Spacer Injection

CPT-55875-PROSTATE-SEED-IMPLANTATION-BRACHYTHERAPY-NEEDLE-PLACEMENT

CPT 55875: Prostate Seed Implantation, Needle/Catheter Placement

CPT-55876-PROSTATE-FIDUCIAL-MARKER-PLACEMENT-FOR-RADIOTHERAPY

CPT 55876: Prostate Marker or Dosimetry Device Placement for Radiotherapy

CPT-55877-PROSTATE-IRE-ABLATION-PERCUTANEOUS

CPT 55877: Prostate Tumor Ablation with Irreversible Electroporation

CPT-55881-TRANSURETHRAL-ULTRASOUND-ABLATION-PROSTATE-MRI-GUIDED

CPT 55881: Transurethral Ultrasound Ablation (TULSA) of Prostate Tissue

CPT-55882-TRANSURETHRAL-ULTRASOUND-ABLATION-PROSTATE-MRI-GUIDED

CPT 55882: MRI-Guided Transurethral Ultrasound Ablation of Prostate Tissue

CPT-55899-MALE-GENITAL-SYSTEM-UNLISTED-PROCEDURE

CPT 55899: Unlisted Procedure, Male Genital System

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`11`	Office or other outpatient visit for evaluation and management	When an unrelated E/M visit occurs on the same day as the procedure and is separately identifiable
`22`	Increased procedural services	When work required is substantially greater than typically required for `55880`
`52`	Reduced services	When the procedure is partially reduced or discontinued
`53`	Discontinued procedure	When the procedure is started but terminated due to extenuating circumstances
`62`	Two surgeons	When two surgeons work together as primary surgeons performing distinct portions
`66`	Surgical team	When a team approach is used with multiple qualified surgeons
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period	For an unplanned re-entry to address a complication
`79`	Unrelated procedure or service by the same physician during the postoperative period	When an unrelated procedure is performed during the global period
`LT`	Left side	When laterality is relevant and the procedure is performed on the left prostate lobe (if laterality reporting required)
`RT`	Right side	When laterality is relevant and the procedure is performed on the right prostate lobe (if laterality reporting required)
`QK`	Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals	When anesthesia direction meets criteria for concurrent cases

Taxonomy Code	Specialty	Notes
363A00000X	Urology	Most common specialty performing HIFU for prostate malignancy
207RH0000X	Radiology — Radiation Oncology	Specialists involved when HIFU integrated into multidisciplinary local tumor control
207L00000X	Diagnostic Radiology	Provides ultrasound imaging guidance and intra-procedural interpretation
363LF0000X	Female Urology	(Included for completeness though uncommon for prostate procedures)
208800000X	Anesthesiology	Provides general/regional anesthesia and perioperative management

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C61`	Malignant neoplasm of prostate	Primary indication for HIFU to ablate localized prostate cancer
`D40.0`	Neoplasm of uncertain behavior of prostate	Situations where focal therapy may be considered for atypical lesions
`N40.0`	Benign prostatic hyperplasia with lower urinary tract symptoms	Coexisting BPH may affect planning and peri-procedural urinary management
`R33.8`	Other retention of urine	Potential peri-procedural complication requiring catheterization
`R31.9`	Hematuria, unspecified	Symptom that can occur after prostate ablation and prompts evaluation

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`51701`	Insertion of temporary indwelling urethral catheter; simple (e.g., straight catheterization)	Often performed before or after HIFU for urinary drainage or retention management
`55866`	Laparoscopic radical prostatectomy	Alternative definitive surgical treatment for localized prostate cancer; may be considered in treatment planning
`76942`	Ultrasonic guidance for needle placement (e.g., diagnostic or therapeutic)	Represents ultrasound guidance procedures; intra-procedural ultrasound guidance is intrinsic to `55880`
`52000`	Cystourethroscopy, diagnostic, with or without collection of specimen(s) by brushing or washing	May be performed if hematuria or urethral concern arises peri-procedurally
`99223`	Initial hospital care, typically 70 minutes or more, per day, for the evaluation and management of a patient	Example of an E/M service that may be billed for hospital admissions related to complications

CPT 55870: Electroejaculation and Semen Collection for Assisted Reproduction

CPT-55873-PROSTATE-CRYOABLATION-ULTRASOUND-GUIDED

CPT 55873: Ultrasound-Guided Prostate Cryoablation

CPT-55874-PROSTATE-BIODEGRADABLE-SPACE-INJECTION-IMAGE-GUIDED

CPT 55874: Image-Guided Prostate Biodegradable Spacer Injection

CPT-55875-PROSTATE-SEED-IMPLANTATION-BRACHYTHERAPY-NEEDLE-PLACEMENT

CPT 55875: Prostate Seed Implantation, Needle/Catheter Placement

CPT-55876-PROSTATE-FIDUCIAL-MARKER-PLACEMENT-FOR-RADIOTHERAPY

CPT 55876: Prostate Marker or Dosimetry Device Placement for Radiotherapy

CPT-55877-PROSTATE-IRE-ABLATION-PERCUTANEOUS

CPT 55877: Prostate Tumor Ablation with Irreversible Electroporation

CPT-55881-TRANSURETHRAL-ULTRASOUND-ABLATION-PROSTATE-MRI-GUIDED

CPT 55881: Transurethral Ultrasound Ablation (TULSA) of Prostate Tissue

CPT-55882-TRANSURETHRAL-ULTRASOUND-ABLATION-PROSTATE-MRI-GUIDED

CPT 55882: MRI-Guided Transurethral Ultrasound Ablation of Prostate Tissue

CPT-55899-MALE-GENITAL-SYSTEM-UNLISTED-PROCEDURE

CPT 55899: Unlisted Procedure, Male Genital System

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 55880: Transrectal HIFU Ablation of Malignant Prostate Tissue

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Billing Code Overview

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CPT 55880: Transrectal HIFU Ablation of Malignant Prostate Tissue

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References