# Medicare NCD 230.9: cryosurgery of the prostate

Source: https://onco.cc/terms/medicare-ncd-230-9/  
OnCo record `medicare-ncd-230-9` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Medicare pays for freezing treatment of the prostate as a first treatment for prostate cancer confined to the gland area (stages T1 to T3), and as a second treatment only after radiotherapy has failed and the cancer still meets set limits.

## Summary

United States, Medicare National Coverage Determination 230.9, version 1, effective 1 July 2001. It states that cryosurgical ablation of the prostate is "safe and effective, as well as medically necessary and appropriate, as primary treatment for patients with clinically localized prostate cancer, Stages T1-T3". Salvage cryosurgery for recurrent cancer is covered only for localised disease in patients who "have failed a trial of radiation therapy as their primary treatment" and meet one of: "Stage T2B or below, Gleason score <9, PSA <8 ng/mL". It is not covered as salvage after failure of other primary treatments, nor for any salvage services before 30 June 2001.

## Fields

- Kind: Term
- Last checked: 2026-11-04
- Also known as: NCD 230.9; Cryosurgery of Prostate; cryosurgical ablation of the prostate; CSAP
- Tags: us

## Sources

- CMS Medicare Coverage Database: the NCD: https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=123&ncdver=1
- CMS Coverage API: the NCD text as data: https://api.coverage.cms.gov/v1/data/ncd?ncdid=123&ncdver=1

## Connected records

- cancers: [Prostate cancer](https://onco.cc/cancers/prostate/)
- technologies: [Cryoablation systems](https://onco.cc/technologies/cryoablation-systems/)
- institutions: [Centers for Medicare & Medicaid Services (CMS)](https://onco.cc/institutions/cms/)
- terms: [Cryoablation](https://onco.cc/terms/cryoablation/), [PSA (prostate-specific antigen)](https://onco.cc/terms/psa/)

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