🔬 CPT 55842 — Prostatectomy, Retropubic Radical, With Or Without Nerve Sparing; With Lymph Node Biopsy(s) (Limited Pelvic Lymphadenectomy)
Quick Reference
wRVU: 20.83 | Global Period: 090 | Assistant Payable: Yes (Modifier -80) | Bilateral Indicator: 0 Rule: CPT 55842 carries a 90-day global period, bundling all pre-operative workup on the day of surgery, the intraoperative procedure itself, and all related post-operative care for 90 days. The bilateral indicator of 0 reflects that the prostate is a single, midline structure — the bilateral billing concept does not apply, and modifiers -RT, -LT, or -50 should never be appended. The limited pelvic lymphadenectomy component distinguishes 55842 from the base radical prostatectomy code 55840 (no lymph node work) and the more extensive 55845 (bilateral pelvic lymphadenectomy including external iliac, hypogastric, and obturator nodes).
📋 Clinical Description
CPT 55842 describes an open retropubic radical prostatectomy — complete surgical removal of the prostate gland and seminal vesicles through a lower midline abdominal incision extending to the retropubic space — combined with a limited pelvic lymph node biopsy to sample regional nodes for staging purposes. The surgeon may elect to spare the neurovascular bundles running alongside the prostate to preserve erectile function, a technique reflected in the “with or without nerve sparing” language built into the code descriptor itself; the presence or absence of nerve sparing does not change the CPT code assigned. This code sits between two closely related siblings: CPT 55840 (the same radical retropubic prostatectomy without any lymph node work) and CPT 55845 (radical retropubic prostatectomy with a more extensive bilateral pelvic lymphadenectomy encompassing the external iliac, hypogastric, and obturator nodal chains).
The limited pelvic lymphadenectomy captured in 55842 typically involves biopsy or removal of a small number of obturator or external iliac nodes for pathologic staging, rather than the comprehensive multi-chain dissection described by 55845. Documentation specificity is critical here — the operative report must clearly state which nodal groups were sampled and whether the dissection was limited (supporting 55842) or extended to all three named chains bilaterally (supporting 55845 instead). This procedure remains one of the most common definitive surgical treatments for clinically localized prostate cancer, particularly in patients with intermediate to high-risk disease features where nodal staging is clinically indicated.
This procedure may be performed in the following clinical contexts:
- Clinically localized intermediate-risk prostate cancer — A patient with biopsy-confirmed adenocarcinoma of the prostate, Gleason score 7, and imaging suggesting disease confined to the gland undergoes retropubic radical prostatectomy with limited pelvic lymph node sampling to confirm pathologic nodal status. The primary diagnosis is C61 with staging supported by pathology results.
- High-risk localized prostate cancer with elevated PSA — A patient presenting with a markedly elevated PSA coded to R97.21 and biopsy-proven high-grade prostate cancer undergoes 55842 to achieve both definitive local tumor control and pathologic nodal staging, informing decisions about adjuvant therapy. Nodal sampling is particularly important in this risk category given higher rates of occult micrometastatic disease.
- Nerve-sparing radical prostatectomy in a sexually active patient — A relatively young patient with organ-confined disease and preserved erectile function pre-operatively undergoes a nerve-sparing technique during the retropubic radical prostatectomy to maximize the likelihood of post-operative potency preservation; the same CPT code 55842 applies regardless of the nerve-sparing decision, though operative documentation of the technique used is still clinically important.
- Salvage or post-radiation retropubic prostatectomy — In select cases, a patient with biochemical recurrence after prior radiation therapy for prostate cancer may undergo a salvage retropubic radical prostatectomy; this is technically more complex due to post-radiation fibrosis and may support modifier -22 for increased procedural services with detailed operative documentation.
- Prostate cancer with documented lower urinary tract symptoms from BPH — A patient with concurrent benign prostatic hyperplasia coded to N40.1 alongside biopsy-confirmed prostate cancer undergoes 55842, addressing both the oncologic indication and pre-existing obstructive symptoms through complete gland removal.
🔬 Anatomical & Procedural Considerations
| Variant | Mechanism | Key Notes |
|---|---|---|
| Nerve-Sparing Technique | The surgeon carefully dissects the prostate away from the neurovascular bundles running posterolaterally along the gland, preserving the nerves responsible for erectile function while still achieving complete oncologic resection of the prostate; this requires meticulous dissection technique and is only performed when oncologically appropriate. | The CPT code 55842 does not change based on whether nerve sparing is performed — the descriptor explicitly states “with or without nerve sparing,” meaning documentation of the technique is clinically relevant but does not affect code selection. Coders should still note the technique in the record for quality and outcomes tracking purposes even though it does not change reimbursement. |
| Non-Nerve-Sparing Technique | When the tumor is close to or invading the neurovascular bundle, or when preserving erectile function would compromise oncologic control, the surgeon performs a wide excision that sacrifices the neurovascular bundle on the affected side; this reduces the likelihood of positive surgical margins in locally advanced disease. | Post-operative erectile dysfunction following non-nerve-sparing prostatectomy is an expected and common outcome; when documented, this may be reported using N52.9 on subsequent encounters as a secondary diagnosis reflecting a known consequence of the surgical treatment. |
| Limited Pelvic Lymphadenectomy | The surgeon samples or removes a limited number of lymph nodes — typically from the obturator fossa or external iliac region — for pathologic staging purposes; this is a more restricted dissection than the comprehensive bilateral lymphadenectomy captured by CPT 55845, which includes the external iliac, hypogastric, and obturator chains bilaterally. | The distinction between “limited” (55842) and “bilateral pelvic” (55845) lymphadenectomy hinges entirely on the extent and laterality of nodal dissection documented in the operative report; coders must review the operative note carefully rather than assuming based on clinical risk category alone, as the surgeon’s actual documented extent of dissection governs code selection. |
Clinical Pearl
The single biggest coding risk with CPT 55842 is misclassifying the extent of lymph node dissection performed. If the operative report describes removal of nodes from only one or two nodal basins (e.g., obturator fossa alone), 55842 is correct; if the report explicitly documents bilateral dissection encompassing the external iliac, hypogastric, AND obturator nodes, the more extensive CPT 55845 is the correct code instead — these codes are mutually exclusive for the same operative session and only one may be reported. Additionally, coders should never separately report a standalone lymph node biopsy code (such as CPT 38571 or 38770) alongside 55842, as the lymphadenectomy work is already bundled into the base prostatectomy code.
✅ Procedure Includes
- Lower midline retropubic surgical approach — Creation of the incision and dissection down through the fascia and rectus muscles to access the retropubic space is included in the global procedure and not separately reportable.
- Complete resection of the prostate gland and seminal vesicles — Removal of the entire prostate along with the attached seminal vesicles is the core oncologic component of the procedure and is fully captured by 55842.
- Urethrovesical anastomosis — Reconnection of the bladder neck to the urethral stump following prostate removal, restoring continuity of the urinary tract, is included in the global surgical package.
- Limited pelvic lymph node biopsy or excision — Sampling of a restricted number of pelvic lymph nodes (typically obturator or external iliac) for pathologic staging is explicitly included in the 55842 code descriptor and is not separately billable.
- Nerve-sparing dissection technique when performed — The additional meticulous dissection required to preserve the neurovascular bundles is included in the base code and does not warrant a separate or increased code.
- Foley catheter placement — Placement of a urethral catheter at the conclusion of the procedure to support healing of the urethrovesical anastomosis is a routine, bundled component of the surgery.
- Intraoperative hemostasis and closure — Control of bleeding throughout the procedure and standard layered wound closure are included in the global surgical package.
- Post-operative management for 90 days — All routine post-prostatectomy follow-up E/M services directly related to the surgery performed within 90 days are bundled into the global period and are not separately billable by the same surgeon.
❌ Excludes / Do Not Report Together
| Code | Description | Relationship |
|---|---|---|
| 55840 | Prostatectomy, retropubic radical, with or without nerve sparing | 55840 describes the identical base procedure without any lymph node work; it is mutually exclusive with 55842 for the same operative session — report 55840 only when no pelvic lymph node sampling was performed, and 55842 only when limited lymph node biopsy was additionally performed. |
| 55845 | Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes | 55845 represents a more extensive nodal dissection than 55842; these two codes are mutually exclusive for the same session, and selection depends entirely on the documented extent of lymphadenectomy — limited sampling supports 55842, while comprehensive bilateral three-chain dissection supports 55845. |
| 51500 | Excision of urachal cyst or sinus, with or without umbilical hernia repair | Not typically performed concurrently, but if documented as a separate distinct procedure at the same session, this would require modifier -59 and clear operative documentation establishing it as unrelated to the prostatectomy itself; this is an uncommon combination requiring careful review. |
| 52000 | Cystourethroscopy (separate procedure) | Cystourethroscopy is considered an inherent component of retropubic radical prostatectomy when performed to assist with catheter placement or visualize the urethral anastomosis; it is not separately reportable as it is bundled into the global surgical package for 55842 under NCCI “separate procedure” designation rules. |
Bundling Alert
CPT 55842 carries a 90-day global period, meaning routine post-operative E/M visits, catheter management, and complication care directly related to the prostatectomy within that window are bundled into the global payment. If the patient returns to the OR within 90 days for a related complication — such as anastomotic leak, hemorrhage, or lymphocele requiring drainage — modifier -78 must be appended, limiting reimbursement to the intraoperative component only. Coders should also watch for improper separate billing of the lymph node dissection component using standalone lymphadenectomy codes (such as 38770), since this work is fully bundled into 55842 per the code’s own descriptor language, and doing so constitutes improper unbundling that is a frequent audit target in urologic oncology billing.
🌳 Code Tree — Surgery: Male Genital System — Prostate
CPT 55700-55899 Surgery: Male Genital System — Prostate
│
├── 55700-55725 Prostate Biopsy Procedures
│ ├── 55705 Prostate biopsy, non-imaging guided
│ └── 55715 Biopsy, prostate, each additional, MRI-ultrasound fusion or in-bore CT- or MRI-guided targeted lesion (add-on)
│
├── 55801-55845 Excision Procedures on the Prostate
│ ├── 55810 Prostatectomy, perineal radical (Global: 090)
│ ├── 55840 Prostatectomy, retropubic radical, with or without nerve sparing (Global: 090)
│ ├── ▶▶ 55842 ◀◀ Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy) ← YOU ARE HERE (Global: 090)
│ └── 55845 Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (Global: 090)
│
└── 55860-55899 Exposure/Laparoscopic Prostate Procedures
├── 55866 Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed (Global: 090)
└── 55869 Laparoscopy, surgical prostatectomy, retropubic radical, with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes, includes robotic assistance, when performed (Global: 090)💰 RVU & Reimbursement Profile
| Component | Value |
|---|---|
| Work RVU | 20.83 |
| Global Period | 090 |
| Bilateral Indicator | 0 — Bilateral concept does not apply |
| Assistant Surgeon | Payable — Modifier -80 (MD assistant) |
| Co‑Surgeon | Not typical; Modifier -62 (Two Surgeons) may apply in select complex or salvage cases requiring distinct surgical expertise |
| Team Surgery | Not typical for this procedure |
| PC/TC Split | 0 — Global only; no professional/technical component split applicable |
| Modifier -51 Exempt | No — Subject to multiple procedure reduction rules when additional procedures are reported |
| Anesthesia | General or regional anesthesia is standard; reported separately under CPT 00865 (Anesthesia for transurethral and radical procedures on the prostate) |
Bilateral Billing Rules
CPT 55842 has a bilateral indicator of 0, meaning the concept of bilateral billing does not apply — the prostate is a single midline organ, so modifiers -RT, -LT, and -50 should never be appended to this code. Any claim submitted with a laterality or bilateral modifier on 55842 will be inconsistent with the procedure’s anatomy and is likely to trigger payer rejection or audit review.
🏷️ Modifier Reference
| Modifier | Name | When to Apply |
|---|---|---|
| -22 | Increased Procedural Services | Apply when the operative complexity is substantially greater than typical — for example, salvage prostatectomy after prior radiation therapy with dense fibrosis, or a markedly enlarged prostate requiring significantly extended operative time; requires a written narrative supporting the additional work. |
| -51 | Multiple Procedures | Append to a secondary procedure when 55842 is performed alongside another separately reportable surgical service at the same session; the lower-valued procedure receives the modifier -51 multiple procedure reduction. |
| -52 | Reduced Services | Use when the procedure is intentionally reduced in scope from what is typically performed — for example, if the lymph node sampling portion could not be completed due to unexpected anatomic constraints, though the prostatectomy itself was completed. |
| -53 | Discontinued Procedure | Apply when the procedure is started but discontinued due to a threat to patient safety, such as significant intraoperative hemorrhage or hemodynamic instability, before the planned resection is completed. |
| -59 | Distinct Procedural Service | Use to identify a separately reportable procedure performed at the same session as 55842 that is clinically distinct from the prostatectomy and its bundled lymph node work; requires clear operative documentation supporting the independence of the additional service. |
| -62 | Two Surgeons | Apply when two surgeons of different specialties or with distinct skill sets are required to perform genuinely separate and distinct portions of a technically complex case, such as a salvage prostatectomy requiring urologic and colorectal surgical expertise; each surgeon bills 55842-62 and documentation must clearly define each surgeon’s distinct role. |
| -78 | Return to OR — Related Procedure | Required when the patient returns to the operating room within the 90-day global period for a complication directly related to the prostatectomy, such as anastomotic leak, hemorrhage, or lymphocele requiring surgical drainage; reimbursement is reduced to the intraoperative component only. |
| -79 | Unrelated Procedure in Global Period | Apply when a procedure clearly unrelated to the prostatectomy is performed during the 90-day global period, such as an unrelated hernia repair; documentation must establish the unrelated nature of the additional procedure. |
| -80 | Assistant Surgeon | Report when a fully qualified MD assistant surgeon participates in the procedure; documentation must reflect the assistant’s specific contribution and medical necessity for the assistance. |
🩺 Common ICD‑10‑CM Pairings
Primary Diagnosis Group
| ICD‑10 | Description | HCC? | Notes |
|---|---|---|---|
| C61 | Malignant neoplasm of prostate | Yes (HCC 12) | The dominant and expected principal diagnosis for CPT 55842; C61 is an HCC-mapped code and should be captured on every encounter where active prostate cancer is documented and being surgically treated. |
| R97.21 | Elevated prostate specific antigen (PSA) | No | May be reported as an additional diagnosis reflecting the pre-operative finding that prompted biopsy and eventual surgical staging; should not replace C61 once a tissue diagnosis of malignancy has been confirmed. |
| N40.1 | Benign prostatic hyperplasia with lower urinary tract symptoms | No | Report as a secondary diagnosis when the patient has concurrent symptomatic BPH alongside the primary cancer diagnosis; this reflects the full clinical picture of the prostate pathology being addressed surgically. |
Secondary Group
| ICD‑10 | Description | HCC? | Notes |
|---|---|---|---|
| N52.9 | Erectile dysfunction, unspecified | No | Report on pre-operative encounters when documented, or on post-operative encounters when erectile dysfunction develops as an expected consequence of non-nerve-sparing technique; must be physician-documented rather than inferred. |
| Z85.46 | Personal history of malignant neoplasm of prostate | No | Used on subsequent encounters after the prostatectomy is complete and the patient is in post-treatment surveillance, once no current evidence of active malignancy remains — not appropriate for the surgical encounter itself when C61 applies. |
Etiology / Complication
| ICD‑10 | Description | HCC? | Notes |
|---|---|---|---|
| N99.11 | Vesicourethral anastomotic stricture following genitourinary procedure | No | Assign on subsequent encounters if the patient develops a urethral stricture at the surgical anastomosis site — a known post-prostatectomy complication requiring physician documentation to support assignment. |
Coding Specificity Reminder
ICD-10 CM C61 does not require additional laterality or subsite specificity in ICD-10-CM, as the prostate is a single midline organ; however, coders must ensure the diagnosis reflects active, current malignancy (C61) versus historical, resolved disease (Z85.46) based on the documentation at the specific encounter being coded. Do not assign both C61 and Z85.46 for the same active treatment encounter — Z85.46 is reserved for encounters after definitive treatment is complete and there is no current evidence of disease.
🏥 MS‑DRG Considerations
CPT 55842 is a designated OR procedure that drives DRG assignment within MDC 12 (Diseases and Disorders of the Male Reproductive System), most commonly mapping to DRG 707 (Major Male Pelvic Procedures with CC/MCC) or DRG 708 (Major Male Pelvic Procedures without CC/MCC), depending on the presence of documented complications or comorbidities. Complete capture of secondary diagnoses — including erectile dysfunction, urinary incontinence, or post-operative complications such as anastomotic stricture — can elevate the DRG to the CC/MCC tier and more accurately reflect the resource intensity of the admission. Inpatient profee coders should ensure the operative report, pathology report, and post-operative course are all reviewed to identify every codable diagnosis supporting the full clinical complexity of the hospitalization.
🔧 ICD‑10‑PCS Equivalents
| PCS Code | Full Description | Modality |
|---|---|---|
| 0VT00ZZ | Resection of Prostate, Open Approach | Open |
| 0VT04ZZ | Resection of Prostate, Percutaneous Endoscopic Approach | Laparoscopic/Robotic |
| 07B40ZZ | Excision of Right Pelvic Lymphatic, Open Approach | Open |
| 07B60ZZ | Excision of Left Pelvic Lymphatic, Open Approach | Open |
PCS Character Analysis (Primary code: 0VT00ZZ)
| Position | Character | Value | Definition |
|---|---|---|---|
| 1 | Section | 0 | Medical and Surgical — the root section governing all invasive operative procedures, including radical prostatectomy. |
| 2 | Body System | V | Male Reproductive System — the prostate is classified under this body system in ICD-10-PCS. |
| 3 | Root Operation | T | Resection — defined as “cutting out or off, without replacement, all of a body part”; this directly maps to the complete removal of the prostate gland described by CPT 55842. |
| 4 | Body Part | 0 | Prostate — the specific anatomical structure being resected in this procedure. |
| 5 | Approach | 0 | Open — the retropubic approach described by CPT 55842 is performed through an open lower midline incision, distinguishing it from the laparoscopic/robotic approach captured by CPT 55866. |
| 6 | Device | Z | No Device — no prosthetic device or implant is left in place following prostate resection. |
| 7 | Qualifier | Z | No Qualifier — no additional qualifying circumstance applies to this specific resection procedure in the PCS framework. |
Root Operation Comparison
- Resection (T) is the correct root operation for CPT 55842 because the entire prostate gland is removed without any portion left behind, distinguishing it from a partial removal.
- Excision would apply only if a portion of the prostate were removed rather than the entire gland — this does not describe the radical prostatectomy captured by 55842, which removes the complete gland.
- The pelvic lymph node component is captured separately using root operation Excision (07B40ZZ, 07B60ZZ) rather than Resection, since only a limited sample of nodes is removed rather than an entire defined lymphatic body part.
📝 Coding Examples
Example 1
Clinical Scenario: A 61-year-old male with biopsy-confirmed Gleason 7 adenocarcinoma of the prostate, clinical stage T2a, and PSA of 8.2 ng/mL is admitted for open retropubic radical prostatectomy. The surgeon performs a nerve-sparing technique on the right side due to tumor location, with non-nerve-sparing dissection on the left where the tumor abuts the neurovascular bundle. A limited pelvic lymph node biopsy of the right obturator fossa is performed and sent for frozen section, returning negative for malignancy. Urethrovesical anastomosis is completed and a Foley catheter is placed.
| Field | Code | Rationale |
|---|---|---|
| CPT | 55842 | Retropubic radical prostatectomy with limited pelvic lymph node biopsy (single obturator fossa sample); nerve-sparing technique performed unilaterally does not change code selection per descriptor language. |
| PDx | C61 | Malignant neoplasm of prostate; biopsy-confirmed active malignancy is the principal diagnosis for this oncologic surgical encounter. |
Note
Because only a single nodal basin (right obturator fossa) was sampled rather than the bilateral three-chain dissection required for 55845, code 55842 is correct. The nerve-sparing technique performed on one side does not affect CPT code selection, as the descriptor for 55842 explicitly states “with or without nerve sparing.”
Example 2
Clinical Scenario: A 58-year-old male with high-risk localized prostate cancer (PSA 22 ng/mL, Gleason 9) undergoes open retropubic radical prostatectomy. Given the high-risk features, the surgeon performs a limited pelvic lymphadenectomy sampling both the right and left obturator nodes, but explicitly does not dissect the external iliac or hypogastric chains, documenting this as a deliberate limited approach given the patient’s overall surgical risk profile.
| Field | Code | Rationale |
|---|---|---|
| CPT 1 | 55842 | Limited pelvic lymphadenectomy is performed bilaterally at the obturator level only — since the external iliac and hypogastric chains are explicitly NOT dissected, this remains a limited lymphadenectomy under 55842 rather than the comprehensive bilateral dissection required for 55845. |
| PDx | C61 | Malignant neoplasm of prostate; high-risk features documented support the surgical indication. |
Warning
Coders must not assume that “bilateral” sampling of any nodes automatically qualifies for CPT 55845 — that code specifically requires dissection of the external iliac, hypogastric, AND obturator chains. Bilateral sampling limited to only the obturator nodes, as documented here, still correctly maps to the limited lymphadenectomy code 55842, not 55845. Misreading “bilateral” in the operative note without confirming all three required nodal chains is a common upcoding error.
Example 3
Clinical Scenario: A 64-year-old male underwent retropubic radical prostatectomy with limited pelvic lymph node biopsy (55842) 35 days ago for localized prostate cancer. He now presents with fever, flank pain, and imaging demonstrating a large pelvic lymphocele causing hydronephrosis. He is taken back to the OR for laparoscopic marsupialization and drainage of the lymphocele, a complication directly attributable to the original lymph node dissection performed during the index prostatectomy.
| Field | Code | Rationale |
|---|---|---|
| CPT | 49323-78 | Laparoscopic drainage of lymphocele to peritoneal cavity; modifier -78 indicates a return to the OR within the 90-day global period of the original 55842 for a directly related complication. |
| PDx | N99.11 | Vesicourethral anastomotic stricture following genitourinary procedure — used here as an illustrative post-prostatectomy complication code category; the specific complication code should match the documented pathology (lymphocele-related obstruction) per physician documentation. |
Global period reminder
The 90-day global period for the original 55842 extends from the date of surgery. Any related return to the OR for a complication of the lymph node dissection — such as a symptomatic lymphocele — requires modifier -78, limiting reimbursement for the return procedure to the intraoperative work RVU component only, since the pre- and post-operative work was already compensated as part of the original global surgical package.
⚠️ Common Coding Pitfalls
- Pitfall 1: Confusing the three closely related codes 55840, 55842, and 55845 based on assumptions about clinical risk category rather than actual documented extent of lymph node dissection; the choice among these three codes depends entirely on what the operative report documents was actually removed, not on the patient’s pre-operative risk stratification.
- Pitfall 2: Separately billing a standalone lymph node biopsy or excision code (such as 38570-series codes) alongside 55842; the lymph node sampling work is explicitly bundled into the 55842 descriptor itself and represents improper unbundling if billed separately.
- Pitfall 3: Appending laterality modifiers -RT, -LT, or bilateral modifier -50 to CPT 55842; the prostate is a single midline organ and the bilateral indicator of 0 confirms these modifiers are inapplicable and will likely trigger claim rejection.
- Pitfall 4: Failing to distinguish active malignancy (C61) from personal history of malignancy (Z85.46) when selecting the principal diagnosis for the surgical encounter; C61 is required for the active surgical treatment encounter, while Z85.46 is reserved for post-treatment surveillance visits.
- Pitfall 5: Billing routine post-operative catheter management or wound checks separately within the 90-day global period without recognizing these services are bundled into the global surgical package; only complications requiring a return to the OR (with modifier -78) or genuinely unrelated services (with modifier -79 or -24) may be separately reported during this window.
- Pitfall 6: Overlooking documentation of nerve-sparing technique in the operative note; while this does not change CPT code selection for 55842, it is clinically significant for quality reporting, patient counseling documentation, and may support future ICD-10-CM code assignment (such as N52.9) if erectile dysfunction develops post-operatively.
📎 Sources
1 AMA CPT 2026 Professional Edition — Code 55842 official descriptor, parenthetical notes, and bundling instructions. 2 CMS 2026 Medicare Physician Fee Schedule Final Rule — Global period (090), bilateral indicator (0), wRVU (20.83) for CPT 55842. 3 AUA Coding Tips & Tricks — CPT Code Updates for 2026, urology-specific guidance on prostatectomy and lymphadenectomy code selection. 4 ICD-10-CM 2026 Official Guidelines for Coding and Reporting — C61 active malignancy versus Z85.46 personal history distinction. 5 AAPC Coding Alert — Prostatectomy coding guidance distinguishing 55840, 55842, and 55845 based on extent of lymph node dissection. 6 ICD-10-PCS 2026 Official Code Set — Root operation Resection (T), Male Reproductive System (V), and character analysis for 0VT00ZZ. 7 CMS 2026 MS-DRG v44 Definitions Manual, MDC 12 — DRG 707/708 definitions and OR procedure designation for 55842. 1. American Medical Association. *CPT 2026 Professional Edition*. AMA Press, 2025. 2. Centers for Medicare & Medicaid Services. *2026 Medicare Physician Fee Schedule Final Rule*. CMS.gov, November 2025. 3. American Urological Association. *Coding Tips and Tricks: CPT Code Updates for 2026*. AUAnews.net, February 2026. 4. Centers for Medicare & Medicaid Services. *ICD-10-CM Official Guidelines for Coding and Reporting FY2026*. CMS.gov, October 2025. 5. AAPC. *Learn How to Approach Prostatectomy Coding, Part 2*. My Urology Coding Alert, 2025. 6. Centers for Medicare & Medicaid Services. *ICD-10-PCS 2026 Official Code Set and Reference Manual*. CMS.gov, October 2025. 7. Centers for Medicare & Medicaid Services. *2026 MS-DRG v44 Definitions Manual, MDC 12*. CMS.gov, October 2025.Sources listed above correspond to superscript citations throughout this note. Verify all Medicare payment figures against your current CMS PFS Lookup tool and applicable MAC LCD prior to claim submission. Please use the latest AAPC/AHIMA Coding Books to verify each code within this note.