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CPT code 59074: Fetal fluid drainage, with ultrasound guidance2026 Medicare rate & RVUs in Virginia

Report this service for ultrasound-guided therapeutic drainage of a fetal fluid collection, such as pleural fluid or fetal ascites.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Virginia, Medicare pays $369.67 for 59074 in the office and $258.69 when it’s performed in a hospital or facility.

$369.67Office (non-facility)
$258.69Hospital or facility
−4.8%vs the national office rate ($388.45)

Check a contract rate as a % of Medicare · 59074 nationwide

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 59074 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Virginia
  2. What 59074 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Virginia compares for 59074

Across 109 of 109 payment localities, the office rate for 59074 runs from $339.02 in Arkansas to $478.39 in Miami, FL. Virginia pays $369.67. The RVUs are the same everywhere; the geographic indexes change the dollars.

59074 in Virginia vs other payment areas
  1. Virginia · this page$369.67
  2. Los Angeles, CA · California$407.05+$37.38
  3. Washington, DC area · District of Columbia$432.89+$63.22
  4. Miami, FL · Florida$478.39+$108.72
  5. Chicago, IL · Illinois$460.97+$91.30
  6. Manhattan, NY · New York$457.74+$88.07
  7. Alaska · Alaska$459.96+$90.29

Other areas in Virginia first, then benchmark localities. Bars start at $0.

Every other payment area

59074 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$344.41$245.62
ArkansasArkansas$339.02$242.04
ArizonaArizona$375.55$266.15
Bakersfield, CACalifornia$386.09$262.35
Chico, CACalifornia$381.77$258.04
El Centro, CACalifornia$382.04$258.31
Fresno, CACalifornia$381.77$258.04
Hanford, CACalifornia$381.77$258.04

59074 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
59074 office rate range by state
State / territoryOffice rate rangeLocalities
AK$459.961
AL$344.411
AR$339.021
AZ$375.551
CA$381.77–$454.1629
CO$389.031
CT$415.881
DC$432.891
DE$381.851
FL$408.65–$478.393
GA$381.27–$402.522
GU$387.911
HI$387.911
IA$341.741
ID$346.691
IL$404.89–$460.974
IN$348.551
KS$345.771
KY$365.701
LA$367.38–$386.222
MA$388.79–$421.152
MD$387.65–$432.893
ME$354.81–$366.892
MI$381.27–$420.082
MN$354.861
MO$364.50–$380.723
MS$351.541
MT$388.341
NC$357.861
ND$356.111
NE$342.011
NH$388.341
NJ$415.59–$429.042
NM$385.841
NV$379.521
NY$364.12–$476.905
OH$374.681
OK$358.841
OR$371.63–$395.382
PA$372.06–$408.732
PR$389.431
RI$391.211
SC$367.871
SD$352.301
TN$348.381
TX$369.89–$409.158
UT$373.101
VA$369.67–$432.892
VI$389.431
VT$359.921
WA$386.32–$424.102
WI$343.921
WV$390.521
WY$374.301

See 59074 in every payment locality

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

Office or facility?

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.

The exact Virginia inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,639

Code
59074
Physician work
5.11
Practice expense
4.89
Malpractice
1.63

GPCI2026.csv

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 59074 in Virginia
ComponentRVULocality factorAdjusted
Physician work5.11× 1.0005.1100
Practice expense4.89× 0.9834.8069
Malpractice1.63× 0.7061.1508
Total RVUs11.0676
Conversion factor× 33.4009

Office rate, Virginia$369.67

Office: (5.11 × 1 + 4.89 × 0.983 + 1.63 × 0.706) × $33.4009 = $369.67

Facility: (5.11 × 1 + 1.51 × 0.983 + 1.63 × 0.706) × $33.4009 = $258.69

Open 59074 in the RVU calculator

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

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)2Paid.
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

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%).

When to use modifier 51

Codes related to 59074

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 59074
CodeHow it relatesOffice range, Virginia
Used instead
59001Amniocentesis, therapeutic fluid reductionUsed to remove excess amniotic fluid, rather than drain a collection within the fetus.No office rate
59070Amnioinfusion, transabdominal approachUsed for ultrasound-guided infusion into the amniotic cavity, not fetal fluid drainage.$384.44
59076Fetal shunt, ultrasound-guided placementPlaces a fetal shunt to divert fluid rather than draining a fetal collection.No office rate

How 59074 has changed in Virginia

59074 · Office / nonfacility

$369.67

Effective 2026-10-01

The base rate is $11.41 higher than on 2025-10-01, moving from $358.26 to $369.67 (3.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $358.26changed to$369.67

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.24 changed to 5.11
    • Practice expense RVU 4.70 changed to 4.89
    • Malpractice RVU 1.59 changed to 1.63
    • Work GPCI 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $369.92changed to$358.26

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.73 changed to 4.70
    • Malpractice RVU 1.60 changed to 1.59

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $363.88changed to$369.92

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $378.91changed to$363.88

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.70 changed to 4.73
    • Malpractice RVU 1.56 changed to 1.60
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $386.64changed to$378.91

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.61 changed to 4.70
    • Malpractice RVU 1.50 changed to 1.56
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $390.33changed to$386.64

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.66 changed to 4.61
    • Malpractice RVU 1.46 changed to 1.50

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $396.62changed to$390.33

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.49 changed to 4.66
    • Malpractice RVU 1.44 changed to 1.46
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $393.67changed to$396.62

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.53 changed to 4.49
    • Malpractice RVU 1.34 changed to 1.44
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $397.49changed to$393.67

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.65 changed to 4.53

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $390.57changed to$397.49

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.92 changed to 4.65
    • Malpractice RVU 0.92 changed to 1.34
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $383.59changed to$390.57

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.73 changed to 4.92
    • Malpractice RVU 1.00 changed to 0.92
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $395.52changed to$383.59

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.71 changed to 4.73
    • Malpractice RVU 1.38 changed to 1.00

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $393.55changed to$395.52

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $389.33changed to$393.55

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.60 changed to 4.71
    • Malpractice RVU 1.44 changed to 1.38
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $394.34changed to$389.33

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.37 changed to 4.60
    • Malpractice RVU 1.51 changed to 1.44
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $394.34

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$369.67$258.69RVU26D
2026-07-01$369.67$258.69RVU26C
2026-04-01$369.67$258.69RVU26B
2026-01-01$369.67$258.69RVU26A
2025-10-01$358.26$286.33RVU25D
2025-07-01$358.26$286.33RVU25C
2025-04-01$358.26$286.33RVU25B
2025-01-01$358.26$286.33RVU25A
2024-10-01$369.92$294.25RVU24D
2024-07-01$369.92$294.25RVU24C
2024-04-01$369.92$294.25RVU24B
2024-03-09$369.92$294.25RVU24AR
2024-01-01$363.88$289.45RVU24A
2023-10-01$378.91$302.09RVU23D
2023-07-01$378.91$302.09RVU23C
2023-04-01$378.91$302.09RVU23B
2023-01-01$378.91$302.09RVU23A
2022-10-01$386.64$308.47RVU22D
2022-07-01$386.64$308.47RVU22C
2022-04-01$386.64$308.47RVU22B
2022-01-01$386.64$308.47RVU22A
2021-10-01$390.33$310.13RVU21D
2021-07-01$390.33$310.13RVU21C
2021-04-01$390.33$310.13RVU21B
2021-01-01$390.33$310.13RVU21A
2020-10-01$396.62$318.65RVU20D
2020-07-01$396.62$318.65RVU20C
2020-04-01$396.62$318.65RVU20B
2020-01-01$396.62$318.65RVU20A
2019-10-01$393.67$315.85RVU19D
2019-07-01$393.67$315.85RVU19C
2019-04-01$393.67$315.85RVU19B
2019-01-01$393.67$315.85RVU19A
2018-10-01$397.49$316.92RVU18D
2018-07-01$397.49$316.92RVU18C
2018-04-01$397.49$316.92RVU18B
2018-01-01$397.49$316.92RVU18AR1
2017-10-01$390.57$307.50RVU17D
2017-07-01$390.57$307.50RVU17C
2017-04-01$390.57$307.50RVU17B
2017-01-01$390.57$307.50RVU17A
2016-10-01$383.59$302.29RVU16D
2016-07-01$383.59$302.29RVU16C
2016-04-01$383.59$302.29RVU16B
2016-01-01$383.59$302.29RVU16A
2015-10-01$395.52$314.99RVU15D
2015-07-01$395.52$314.99RVU15C
2015-04-01$393.55$313.42RVU15B
2015-01-01$393.55$313.42RVU15A
2014-10-01$389.33$313.15RVU14D
2014-07-01$389.33$313.15RVU14C
2014-04-01$389.33$313.15RVU14B
2014-01-01$389.33$313.15RVU14A
2013-10-01$394.34$301.60RVU13D
2013-07-01$394.34$301.60RVU13C
2013-04-01$394.34$301.60RVU13B
2013-01-01$394.34$301.60RVU13AR

Price 59074 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

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

Show the CMS file lines behind this rate
RVUs for 59074PPRRVU2026_Oct_nonQPP.csv, line 6,639 (RVU26D)
Geographic factors for VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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