New prostate biopsy CPT codes

[Katyatbeach]

I work for a Urology practice in Georgia and our part B Medicare is denying the CPT code 55707 for POS 11. Is anyone else having this issue? This has to be an error on Medicare's part but I am unable to find any documents that address this issue.

 

[beulastella]

CPT 55707 should be payable in POS 11 (Office), so widespread denials often indicate payer system edits that haven't been updated for the new 2026 prostate biopsy codes.
the Medicare Physician Fee Schedule shows non-facility RVUs/payment for 55707, which confirms that CMS expects the procedure to be billed in an office setting as well
invalid for POS 11 usually points to a claims processing edit error