Prostatectomy, laparoscopic
What goes into a price?
Negotiated prices across insurers
Self pay or cash prices vary by facility when paying out of pocket without insurance benefits. The chart shows you how the lowest and highest amounts facilities charge for this service if you were paying without insurance benefits. If you're uninsured or not submitting a claim to insurance, you also have the right to a Good Faith Estimate under federal law. Contact the provider for a copy of your Good Faith Estimate or to better understand payment options available to you.
Procedures included in this package
This list includes the services and fees bundled into the Prostatectomy, laparoscopic Standard Service Package (SSP RE006). The final price for the procedure will depend on which services your provider ultimately performs, your insurance plan and your medical benefits.
| Code | Code Type | Description |
|---|---|---|
| HCPCS J1885 | Facility Fee | Intramuscular injection of 15mg ketorolac tromethamine |
| HCPCS J3010 | Facility Fee | Intramuscular injection of fentanyl citrate, 0.1mg |
| HCPCS 55866 | Professional Fee | Laparoscopic Robotic-assisted Retropubic Radical Prostatectomy with Nerve Sparing |
| HCPCS J1644 | Facility Fee | Intramuscular Injection of Anti-coagulant Heparin 1000 Units |
| HCPCS 80048 | Facility Fee | Basic metabolic panel including calcium, bicarbonate, chloride, creatinine, glucose, potassium, sodium and BUN |
| HCPCS J0690 | Facility Fee | Intramuscular injection cefazolin sodium, 500mg |
| HCPCS J2405 | Facility Fee | Intramuscular injection of ondansetron hydrochloride, 1mg |
| HCPCS J2250 | Facility Fee | Intramuscular injection of 1mg midazolam hydrochloride |
| HCPCS 38571 | Facility Fee | Laparoscopic Surgical Removal of Pelvic Lymph Nodes Bilaterally |
| HCPCS J1100 | Facility Fee | Intramuscular injection of 1mg dexamethasone sodium phosphate |
| HCPCS 55866 | Facility Fee | Laparoscopic Robotic-assisted Retropubic Radical Prostatectomy with Nerve Sparing |
| HCPCS 88309 | Facility Fee | Surgical Pathology, Gross/Microscopic Examination; Resection Tumor/Neoplasm; Dissection/Disarticulation |
| HCPCS 38571 | Professional Fee | Laparoscopic Surgical Removal of Pelvic Lymph Nodes Bilaterally |
| HCPCS 85027 | Facility Fee | Complete blood count (CBC) – basic blood cell count |