# CPT 55874

> Medicare paid $3,260.76 for CPT 55874 in the office (non-facility) setting and $166.44 in a facility under the Q4 2021 Physician Fee Schedule, effective October 2021. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2021, when it increased 3.7%.

## What it is

A needle is passed through the skin of the perineum, the area between the scrotum and anus, under ultrasound guidance, and an absorbable gel is injected into the thin space between the prostate and the front wall of the rectum. The gel pushes the rectum roughly a centimeter away from the prostate and holds it there for the duration of radiation treatment, so less of the rectal wall sits in the high-dose beam. The material dissolves and is cleared by the body over the following months.

## Selected release

- Release: Q4 2021 (2021 D)
- Effective: October 1 – December 31, 2021
- Status indicator: A
- Office (non-facility) national allowed amount: $3260.76
- Facility national allowed amount: $166.44
- Sequestration: not applied

## RVUs and formula

- Work RVU: 3.03
- Office (non-facility) practice expense RVU: 90.15
- Facility practice expense RVU: 1.47
- Malpractice RVU: 0.27
- Conversion factor: 34.8931
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## Source and citation

- Source: Physician relative value file (Q4 2021)
- CMS file: https://www.cms.gov/files/zip/rvu21d.zip
- Parsed file: PPRRVU21_OCT.csv, row 10,865
- Canonical page: https://localishealth.com/cpt/55874/2021/A
- Release-specific citation URL: https://localishealth.com/cpt/55874/2021/D
- Last significant update: 2026-08-04T03:10:59+00:00