CPT code 59121: Ectopic surgery, tubal or ovarian, organ preserved2026 Medicare rate & RVUs in Missouri
Reports open abdominal surgery for a tubal or ovarian ectopic pregnancy when the pregnancy is treated without removing the affected tube or ovary.
CMS doesn’t publish an office rate for 59121 in Missouri.
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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What 59121 covers
An obstetrician-gynecologist typically reports this for open abdominal surgery to treat a tubal or ovarian ectopic pregnancy while preserving the affected tube or ovary. The operation may involve opening the tube or ovary and removing the ectopic gestational tissue; the defining distinction is that salpingectomy and oophorectomy are not performed. The service is generally provided in an operating room when surgical treatment is needed.
The operative report should identify the ectopic site, the open approach, the treatment performed, and preservation of the tube or ovary. This code has a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery services may be paid; co-surgeons require supporting documentation, and team surgery is 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 59121 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $720.67 |
| Metropolitan St. Louis, MO | Unavailable | $726.43 |
| Rest of Missouri | Unavailable | $705.84 |
How the 59121 rate is calculated
Each of 59121’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 · 59121
RVUs × geographic indexes × conversion factor
Work12.42
12.42 RVUs× 1.000 GPCI
Practice expense5.61
5.61 RVUs× 1.000 GPCI
Malpractice3.98
3.98 RVUs× 1.000 GPCI
Adjusted RVUs
22.0100
Conversion factor
$33.4009
Medicare rate
$735.15
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 59121
59121 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 59121
Ectopic surgery, tubal or ovarian, organ preserved
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are 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) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.17/0.60/0.23 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 59121
Ectopic surgery, tubal or ovarian, organ preserved
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
59121 without 51 · national facility
$735.15
Ectopic surgery, tubal or ovarian, organ preserved
59121-51 · Second procedure: 50%
$367.58
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%).
59121 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 59120Ectopic surgeryTubal or ovarian, organ removed
- Both describe open treatment of tubal or ovarian ectopic pregnancy. Choose 59120 when salpingectomy and/or oophorectomy is performed; choose 59121 when the affected organ is preserved.
- 59150Ectopic surgeryLaparoscopic, without organ removal
- 59150 is the laparoscopic counterpart when the tube and ovary are preserved. 59121 describes open abdominal treatment.
- 59151Ectopic pregnancy surgeryLaparoscopic removal
- 59151 describes laparoscopic treatment with salpingectomy and/or oophorectomy; 59121 is open treatment without removal of the affected tube or ovary.
- 59130Ectopic surgeryAbdominal implantation
- 59130 addresses an abdominal ectopic pregnancy. 59121 is for a tubal or ovarian ectopic pregnancy treated through an open abdominal approach.
59121 billing questions
How does this differ from 59120?
59121 is for open treatment of a tubal or ovarian ectopic pregnancy without removing the affected tube or ovary. 59120 includes salpingectomy and/or oophorectomy.
When should 59150 or 59151 be considered?
Those codes describe laparoscopic treatment of ectopic pregnancy. 59150 is the laparoscopic option without salpingectomy or oophorectomy; 59151 includes removal of the tube and/or ovary.
What documentation supports reporting 59121?
Document the tubal or ovarian ectopic site, the open abdominal approach, the treatment performed, and that the tube or ovary was preserved.
Does modifier 50 apply when both sides are involved?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.
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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