CPT code 59074: Fetal fluid drainage, with ultrasound guidance2026 Medicare rate & RVUs
Report this service for ultrasound-guided therapeutic drainage of a fetal fluid collection, such as pleural fluid or fetal ascites.
Medicare pays $388.45 for 59074 nationally in the office and $275.56 in a hospital or facility. Local office rates run $339.02–$478.39.
Medicare rate · 59074
Fetal fluid drainage, with ultrasound guidance
- Work RVUs
- 5.11
- Total RVUs
- 11.63
- Global days
- 000
National rate · 2026
$388.45
Office setting, before claim adjustments.
See every locality for 59074 →Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 10 sections
What 59074 covers
This procedure drains fluid from a collection within the fetus, rather than removing amniotic fluid from the uterus. Examples include fetal thoracentesis for a pleural effusion and fetal paracentesis for ascites. A maternal-fetal medicine specialist or fetal therapy physician typically performs the intervention in a hospital setting, using ultrasound to guide access and monitor the fetus during drainage. Ultrasound guidance is part of the reported service.
Choose the code when the treatment is drainage of fetal fluid; document the collection’s location, the therapeutic reason, and the procedure performed. Distinguish this from therapeutic amniocentesis, which removes amniotic fluid. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others are subject to the standard multiple procedure reduction. Bilateral adjustment is inappropriate. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 59074 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$339.02 to $478.39
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $344.41 | $245.62 |
| Alaska | $459.96 | $339.73 |
| Arizona | $375.55 | $266.15 |
| Arkansas | $339.02 | $242.04 |
| Atlanta, GA | $402.52 | $287.82 |
| Austin, TX | $392.06 | $272.62 |
| Bakersfield, CA | $386.09 | $262.35 |
| Baltimore area, MD | $416.01 | $294.87 |
| Beaumont, TX | $369.89 | $267.15 |
| Brazoria, TX | $376.37 | $264.49 |
| Chicago, IL | $460.97 | $347.51 |
| Chico, CA | $381.77 | $258.04 |
| Colorado | $389.03 | $268.91 |
| Connecticut | $415.88 | $294.29 |
| Dallas, TX | $381.60 | $269.16 |
| Delaware | $381.85 | $270.31 |
| Detroit, MI | $420.08 | $311.14 |
| East St. Louis, IL | $430.59 | $326.73 |
| El Centro, CA | $382.04 | $258.31 |
| Fort Lauderdale, FL | $434.57 | $320.20 |
| Fort Worth, TX | $380.68 | $269.36 |
| Fresno, CA | $381.77 | $258.04 |
| Galveston, TX | $379.31 | $267.21 |
| Hanford, CA | $381.77 | $258.04 |
| Hawaii, Guam, HI | $387.91 | $259.55 |
| Houston, TX | $409.15 | $297.04 |
| Idaho | $346.69 | $242.83 |
| Indiana | $348.55 | $243.89 |
| Iowa | $341.74 | $238.44 |
| Kansas | $345.77 | $243.71 |
| Kentucky | $365.70 | $265.33 |
| King County, WA | $424.10 | $285.58 |
| Los Angeles, CA | $407.05 | $273.49 |
| Madera, CA | $381.77 | $258.04 |
| Manhattan, NY | $457.74 | $326.56 |
| Marin County, CA | $442.18 | $283.00 |
| Merced, CA | $381.77 | $258.04 |
| Metropolitan Boston, MA | $421.15 | $286.35 |
| Metropolitan Kansas City, MO | $377.24 | $271.23 |
| Metropolitan Philadelphia, PA | $408.73 | $291.21 |
| Metropolitan St. Louis, MO | $380.72 | $273.25 |
| Miami, FL | $478.39 | $360.87 |
| Minnesota | $354.86 | $238.69 |
| Mississippi | $351.54 | $254.34 |
| Modesto, CA | $381.77 | $258.04 |
| Montana | $388.34 | $275.45 |
| Napa, CA | $424.36 | $275.56 |
| Nebraska | $342.01 | $237.81 |
| Nevada | $379.52 | $266.52 |
| New Hampshire | $388.34 | $270.82 |
| New Mexico | $385.84 | $282.31 |
| New Orleans, LA | $386.22 | $279.99 |
| North Carolina | $357.86 | $252.52 |
| North Dakota | $356.11 | $243.22 |
| Northern New Jersey | $429.04 | $298.08 |
| NYC suburbs and Long Island, NY | $476.90 | $342.67 |
| Ohio | $374.68 | $271.61 |
| Oklahoma | $358.84 | $258.02 |
| Oxnard, CA | $402.43 | $268.99 |
| Portland, OR | $395.38 | $269.95 |
| Poughkeepsie and northern NYC suburbs, NY | $423.08 | $299.46 |
| Puerto Rico | $389.43 | $275.30 |
| Queens, NY | $453.17 | $319.72 |
| Redding, CA | $381.77 | $258.04 |
| Rest of California | $381.77 | $258.04 |
| Rest of Florida | $408.65 | $300.72 |
| Rest of Georgia | $381.27 | $280.56 |
| Rest of Illinois | $404.89 | $301.82 |
| Rest of Louisiana | $367.38 | $267.47 |
| Rest of Maine | $354.81 | $250.94 |
| Rest of Maryland | $387.65 | $273.41 |
| Rest of Massachusetts | $388.79 | $269.91 |
| Rest of Michigan | $381.27 | $278.19 |
| Rest of Missouri | $364.50 | $267.18 |
| Rest of New Jersey | $415.59 | $292.31 |
| Rest of New York | $364.12 | $256.87 |
| Rest of Oregon | $371.63 | $259.19 |
| Rest of Pennsylvania | $372.06 | $268.43 |
| Rest of Texas | $374.84 | $267.70 |
| Rest of Washington | $386.32 | $267.44 |
| Rhode Island | $391.21 | $274.58 |
| Riverside, CA | $399.20 | $275.47 |
| Sacramento, CA | $395.96 | $264.66 |
| Salinas, CA | $394.45 | $263.61 |
| San Benito County, CA | $454.16 | $291.36 |
| San Diego, CA | $400.65 | $265.63 |
| San Francisco, CA | $440.33 | $281.15 |
| San Luis Obispo, CA | $388.80 | $260.21 |
| Santa Clara County, CA | $446.59 | $283.80 |
| Santa Cruz, CA | $401.89 | $264.72 |
| Santa Maria, CA | $395.08 | $263.45 |
| Santa Rosa, CA | $405.55 | $266.92 |
| South Carolina | $367.87 | $263.56 |
| South Dakota | $352.30 | $239.41 |
| Southern Maine, ME | $366.89 | $255.01 |
| Stockton, CA | $381.77 | $258.04 |
| Suburban Chicago, IL | $436.09 | $320.14 |
| Tennessee | $348.38 | $245.76 |
| Utah | $373.10 | $266.98 |
| Vallejo, CA | $421.69 | $272.89 |
| Vermont | $359.92 | $248.16 |
| Virgin Islands, VI | $389.43 | $275.30 |
| Virginia | $369.67 | $258.69 |
| Visalia, CA | $381.77 | $258.04 |
| Washington, DC area | $432.89 | $299.90 |
| West Virginia | $390.52 | $292.42 |
| Wisconsin | $343.92 | $235.76 |
| Wyoming | $374.30 | $261.40 |
| Yuba City, CA | $381.77 | $258.04 |
59074 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$339.02
$459.96
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $459.96 | 1 |
| AL | $344.41 | 1 |
| AR | $339.02 | 1 |
| AZ | $375.55 | 1 |
| CA | $381.77–$454.16 | 29 |
| CO | $389.03 | 1 |
| CT | $415.88 | 1 |
| DC | $432.89 | 1 |
| DE | $381.85 | 1 |
| FL | $408.65–$478.39 | 3 |
| GA | $381.27–$402.52 | 2 |
| GU | $387.91 | 1 |
| HI | $387.91 | 1 |
| IA | $341.74 | 1 |
| ID | $346.69 | 1 |
| IL | $404.89–$460.97 | 4 |
| IN | $348.55 | 1 |
| KS | $345.77 | 1 |
| KY | $365.70 | 1 |
| LA | $367.38–$386.22 | 2 |
| MA | $388.79–$421.15 | 2 |
| MD | $387.65–$432.89 | 3 |
| ME | $354.81–$366.89 | 2 |
| MI | $381.27–$420.08 | 2 |
| MN | $354.86 | 1 |
| MO | $364.50–$380.72 | 3 |
| MS | $351.54 | 1 |
| MT | $388.34 | 1 |
| NC | $357.86 | 1 |
| ND | $356.11 | 1 |
| NE | $342.01 | 1 |
| NH | $388.34 | 1 |
| NJ | $415.59–$429.04 | 2 |
| NM | $385.84 | 1 |
| NV | $379.52 | 1 |
| NY | $364.12–$476.90 | 5 |
| OH | $374.68 | 1 |
| OK | $358.84 | 1 |
| OR | $371.63–$395.38 | 2 |
| PA | $372.06–$408.73 | 2 |
| PR | $389.43 | 1 |
| RI | $391.21 | 1 |
| SC | $367.87 | 1 |
| SD | $352.30 | 1 |
| TN | $348.38 | 1 |
| TX | $369.89–$409.15 | 8 |
| UT | $373.10 | 1 |
| VA | $369.67–$432.89 | 2 |
| VI | $389.43 | 1 |
| VT | $359.92 | 1 |
| WA | $386.32–$424.10 | 2 |
| WI | $343.92 | 1 |
| WV | $390.52 | 1 |
| WY | $374.30 | 1 |
How the 59074 rate is calculated
Each of 59074’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 · 59074
RVUs × geographic indexes × conversion factor
Work5.11
5.11 RVUs× 1.000 GPCI
Practice expense4.89
4.89 RVUs× 1.000 GPCI
Malpractice1.63
1.63 RVUs× 1.000 GPCI
Adjusted RVUs
11.6300
Conversion factor
$33.4009
Medicare rate
$388.45
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 59074
The CMS indicators that decide how 59074 is paid alongside other services.
CMS payment indicators · 59074
Fetal fluid drainage, with ultrasound guidance
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
59074 without 51 · national office
$388.45
Fetal fluid drainage, with ultrasound guidance
59074-51 · Second procedure: 50%
$194.23
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%).
59074 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 59001AmniocentesisTherapeutic fluid reduction
- 59074 drains fluid from within the fetus; 59001 removes excess fluid from the amniotic cavity.
- 59070AmnioinfusionTransabdominal approach
- 59074 drains a fetal fluid collection. 59070 infuses fluid into the amniotic cavity.
- 59076Fetal shuntUltrasound-guided placement
- 59074 drains a fetal fluid collection; 59076 places a shunt to divert fluid.
- 59000AmniocentesisDiagnostic fluid sampling
- 59000 is diagnostic amniocentesis for sampling amniotic fluid. 59074 is therapeutic drainage of fluid within the fetus.
59074 billing questions
When should this be reported instead of therapeutic amniocentesis?
Report 59074 for drainage of a fluid collection within the fetus, such as a pleural effusion or ascites. Therapeutic amniocentesis removes excess amniotic fluid from the amniotic cavity.
Is ultrasound guidance separately reported?
No. Ultrasound guidance is included in the fetal fluid drainage service.
What documentation supports reporting 59074?
Document the fetal fluid collection and its location, the clinical reason for drainage, and the drainage procedure performed. For example, identify a pleural effusion when performing fetal thoracentesis.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures performed in that session are paid at 50%.
Can an assistant, co-surgeon, or surgical team be reported?
An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted for this code.
Does the procedure have a postoperative global period?
It has a 0-day global period. Same-day preoperative and postoperative care is included.
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
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