CPT 55866 is a laparoscopic or robotic radical prostatectomy: removal of the whole prostate for cancer, with lymph nodes when needed. It is a two- to four-hour operation with a one- or two-night hospital stay and several weeks of recovery. Most hospitals bill it as an inpatient stay under a DRG rather than by this CPT code, so the number here is often a component rather than the whole episode.
What the price covers
The hospital's price is the facility fee for the operating room, robotic equipment, nursing and supplies for the operation itself. Room and board for the stay, the surgeon, anesthesia, pathology and follow-up are separate. Ask for the inpatient package price if you are paying cash.
Why prices vary
Robotic prostatectomy is concentrated at high-volume centers, and their listed prices are high but their outcomes are usually better. Surgeon experience matters more than price for this operation; use these numbers to check a bill and to compare between experienced surgeons, not to pick the cheapest.
Questions to ask
- What is the total self-pay price for the episode, not just 55866?
- What do surgeon, anesthesia and pathology add?
- How many of these operations does the surgeon do per year?