CPT 55882 TULSA Reimbursement & Policy | OpenPayer

Summary & Overview

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

CPT code 55882 designates MRI-guided transurethral ultrasound ablation (TULSA) of prostate tissue, a minimally invasive image-guided procedure that delivers therapeutic ultrasound via a transurethral transducer to ablate targeted prostate tissue. The code captures services where the provider performs the ablation with MRI guidance and may include adjunctive steps such as suprapubic bladder drainage and endorectal cooling to protect surrounding structures. Nationally, this code is relevant as advanced prostate ablation technologies expand treatment options for benign prostatic hyperplasia and localized prostate neoplasms, and as payers refine coverage and payment policies for MRI-guided focal therapies.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and procedure components, common billing and coding considerations, and typical site-of-service implications. The publication summarizes benchmarking and policy updates where available, highlights documentation and imaging requirements implicit to MRI-guided ablation, and outlines areas where coverage varies or is evolving. Data not available in the input are noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 55882TULSAprostate ablationMRI-guided therapyurologyimage-guided surgeryambulatory surgeryhospital outpatient

Billing Code Overview

CPT code 55882 describes transurethral ultrasound ablation (TULSA) of prostate tissue with MRI guidance. The procedure involves insertion of a transducer into the urethra to deliver therapeutic ultrasound energy to ablate prostate tissue under magnetic resonance imaging (MRI) guidance. The provider may also insert a suprapubic tube for bladder drainage and may place an endorectal cooling device to protect surrounding tissues during the ablation.

Service type: Image-guided prostate tissue ablation using transurethral ultrasound

Typical site of service: Hospital outpatient department or ambulatory surgery center with MRI capability

Clinical & Coding Specifications

Clinical Context

A 68-year-old male with symptomatic localized prostate cancer or medically refractory benign prostatic hyperplasia is scheduled for MRI-guided transurethral ultrasound ablation (TULSA). The patient has pre-procedure multiparametric MRI confirming targetable lesion(s) and meets device-specific criteria for prostate size and anatomy. On the day of service the patient arrives to an outpatient ambulatory surgery center or hospital operating room under monitored anesthesia care or general anesthesia. The provider inserts a transducer transurethrally, may place a suprapubic drainage tube for bladder decompression, and may position an endorectal cooling device to protect the rectal wall. Real-time MRI guidance is used to plan, target, and monitor thermal ablation of prostate tissue while the team monitors core temperature and neurovascular structures. After completion, the transducer and any drains or cooling devices are removed or secured, post-ablation MRI sequences are obtained to confirm treatment effect, and the patient is recovered in PACU with discharge instructions or admitted if clinically indicated.

Coding Specifications

Modifier	Description	When to Use
`00`	No surgical modifier (placeholder)	Use when no other modifier applies to the professional/surgical service.
`22`

CPT 55880: Transrectal HIFU Ablation of Malignant Prostate Tissue

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

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

CPT-55870-EJACULATORY-STIMULATION-AND-SEMEN-COLLECTION

CPT 55870: Electroejaculation and Semen Collection for Assisted Reproduction

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

CPT 55899: Unlisted Procedure, Male Genital System

CPT-55877-PROSTATE-IRE-ABLATION-PERCUTANEOUS

CPT 55877: Prostate Tumor Ablation with Irreversible Electroporation

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-55873-PROSTATE-CRYOABLATION-ULTRASOUND-GUIDED

CPT 55873: Ultrasound-Guided Prostate Cryoablation

Taxonomy Code	Specialty	Notes
`2084P0800X`	Urology	Urologists commonly perform or coordinate TULSA procedures.
`208D00000X`	Radiation Oncology	Radiation oncologists may participate in image-guided prostate ablation planning and follow-up.
`207K00000X`	Diagnostic Radiology	Interventional and diagnostic radiologists provide MRI guidance and intra-procedural imaging.
`208100000X`	Surgical Oncology	Surgical oncologists with genitourinary focus may perform or consult on complex cases.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C61`	Malignant neoplasm of prostate	Primary cancer diagnosis commonly treated with focal or whole-gland TULSA for localized prostate cancer.
`N40.0`	Benign prostatic hyperplasia with lower urinary tract symptoms	BPH with obstructive symptoms may be treated with TULSA in select patients seeking minimally invasive thermal ablation.
`N13.7`	Hydronephrosis with ureterovesical junction obstruction	May be a related urinary complication requiring drainage management before or after TULSA.
`N32.0`	Bladder pain syndrome	Relevant as a comorbid pelvic pain diagnosis that may affect peri-procedural management.
`R33.8`	Other retention of urine	Acute or chronic urinary retention can be an indication for prostate-directed therapy including TULSA in select contexts.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`52234`	Cystourethroscopy, with insertion of indwelling ureteral stent (if performed)	May be performed pre- or post-TULSA to secure urinary drainage or evaluate urethra/bladder.
`52000`	Cystourethroscopy, with urethral dilation and/or meatotomy (separate procedure)	May be performed prior to transurethral device insertion if urethral narrowing impedes transducer placement.
`72197`	MRI guidance for needle placement (percutaneous)	Related MRI guidance code representing advanced imaging support; MRI services for TULSA are integral to the procedure and imaging codes may be reported per payer rules.
`51701`	Irrigation of bladder, simple (catheter irrigation)	May be used post-procedure for bladder management if drainage catheters are placed.
`52310`	Cystourethroscopy, with removal of ureteral stent (if applicable)	May be performed if stents or temporary drains require later endoscopic removal.

OpenPayer