What is the standard insurance baseline for CPT 55880?

The standard insurance baseline reimbursement rate is $976.34. This represents the customary allowable amount established across standard fee schedules.

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CPT 55880Medical Service

High-intensity Ultrasound Destruction of Cancerous Tissue in Prostate Gland

Q: What do doctors typically charge for High-intensity Ultrasound Destruction of Cancerous Tissue in Prostate Gland?

The nationwide median physician charge for High-intensity Ultrasound Destruction of Cancerous Tissue in Prostate Gland (CPT 55880) is $3500.00. Doctor billed charges vary based on geographic region, setting, and overhead.

High-intensity ultrasound destruction of cancerous tissue in prostate gland, accessed through rectum using ultrasound guidance. Clinical pricing breakdown and utilization metrics across 21 practicing doctors nationwide.

$3500.00

Peer Median Charge

Gross billed rate

$976.34

Standard Baseline

Customary allowable

3.6x

National Markup

Charge vs baseline

Active Physicians

Billing this code

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Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $3500.00. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $976.34 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:

"Does Dr. [Name] participate in my specific insurance plan network?"
"What is the total self-pay or cash rate for code 55880 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"