CPT 55868 Surgery - Male Genital

How Much Does Laparoscopic Srg Prst8ct Lymph Nod Biopsy Cost?

Also known as: Lap srg prst8ct lymph nod bx (CPT 55868)

The total estimated cost of Laparoscopic Srg Prst8ct Lymph Nod Biopsy (CPT 55868) is $3,722 to $6,978, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $1,108.

Total Estimated Cost of Care

$3,722 — $6,978

This estimate includes hospital facility fees, anesthesia, and supplies .

Surgeon/Physician Fee
$1,108
Hospital Facility Fee
$3,323
Anesthesia (est.)
$222
Important: The physician fee of $1,108 shown in the cost cards below is what Medicare pays the surgeon/doctor only. The hospital charges a separate facility fee that typically makes up 70-85% of the total cost.
Medicare Physician Fee (Facility Setting)
$1,108
Physician component only — CMS PFS 2026

Procedures Commonly Done Together

These procedures are frequently performed alongside Lap srg prst8ct lymph nod bx

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How to Reduce Your Cost for Lap srg prst8ct lymph nod bx

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

22.46
Work RVU
7.79
Practice Expense RVU
2.91
Malpractice RVU
33.16
Total RVU

Payment = Total RVU (33.16) x CF ($33.40) = $1,108

Frequently Asked Questions

How much does Lap srg prst8ct lymph nod bx cost?

The Medicare facility rate for Lap srg prst8ct lymph nod bx is $1,108. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Lap srg prst8ct lymph nod bx cost without insurance?

Without insurance, the cost of Lap srg prst8ct lymph nod bx can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Lap srg prst8ct lymph nod bx?

Most commercial health insurance plans and Medicare cover Lap srg prst8ct lymph nod bx when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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