CPT code 59072: Cord occlusion, ultrasound-guided fetal procedure2026 Medicare rate & RVUs in Elgin, Texas

CPT 59072: $449.95–$457.24 facility across 2 localities in Elgin, TX in 2026 Medicare. Compare each area.

CMS RVU26DEffective Oct 1, 20262 payment localities

CMS doesn’t publish an office rate for 59072 in Elgin, Texas.

—Office (non-facility)
$449.95–$457.24Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 59072 for the payment locality that covers the ZIP.

On this page 6 sections
  1. Rate in Elgin, Texas
  2. By payment locality
  3. City and payment areas
  4. How it’s calculated
  5. Payment rules
  6. Sources

Where 59072 pays more and less in Elgin, Texas

Elgin, Texas maps to 2 Medicare payment localities in our Census-to-CMS crosswalk. A city name alone doesn’t confirm an address’s payment area.

59072 office and facility rates by payment locality
Payment localityOfficeFacility
Austin, TXUnavailable$457.24
Rest of TexasUnavailable$449.95

How payment areas work in Elgin

City limits and Medicare payment areas are different maps. These are the payment areas that cover the city’s counties; the service ZIP decides which one applies.

  • Rest Of State · Bastrop County
  • Austin · Travis County

City boundaries: 2026 Census geography · Census source · CMS county-to-locality definitions

How the 59072 rate is calculated

Each of 59072’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 59072

RVUs × geographic indexes × conversion factor

Office or facility?

Work8.77

8.77 RVUs× 1.000 GPCI

Practice expense2.28

2.28 RVUs× 1.000 GPCI

Malpractice2.81

2.81 RVUs× 1.000 GPCI

Adjusted RVUs

13.8600

Conversion factor

$33.4009

Medicare rate

$462.94

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 59072

The CMS indicators that decide how 59072 is paid alongside other services.

CMS payment indicators · 59072

Cord occlusion, ultrasound-guided fetal procedure

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

59072 without 51 · national facility

$462.94

Cord occlusion, ultrasound-guided fetal procedure

59072-51 · Second procedure: 50%

$231.47

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 59072PPRRVU2026_Oct_nonQPP.csv, line 6,638 (RVU26D)

Open CMS sourceHow we calculate rates

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