CPT code 59121: Ectopic surgery, tubal or ovarian, organ preserved2026 Medicare rate & RVUs in Virginia

Reports open abdominal surgery for a tubal or ovarian ectopic pregnancy when the pregnancy is treated without removing the affected tube or ovary.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Virginia, Medicare pays $692.89 for 59121 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$692.89Hospital or facility

Check a contract rate as a % of Medicare · 59121 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 59121 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Virginia
  2. What 59121 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 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.

How Virginia compares for 59121

Across 109 of 109 payment localities, the facility rate for 59121 runs from $635.29 in Wisconsin to $946.09 in Miami, FL. Virginia pays $692.89. The RVUs are the same everywhere; the geographic indexes change the dollars.

59121 in Virginia vs other payment areas
  1. Virginia · this page$692.89
  2. Los Angeles, CA · California$741.79+$48.90
  3. Washington, DC area · District of Columbia$805.93+$113.04
  4. Miami, FL · Florida$946.09+$253.20
  5. Chicago, IL · Illinois$911.15+$218.26
  6. Manhattan, NY · New York$869.96+$177.07
  7. Alaska · Alaska$895.06+$202.17

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

Every other payment area

59121 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$654.04
ArkansasArkansas—$644.26
ArizonaArizona—$710.20
Bakersfield, CACalifornia—$709.05
Chico, CACalifornia—$698.51
El Centro, CACalifornia—$699.18
Fresno, CACalifornia—$698.51
Hanford, CACalifornia—$698.51

59121 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.

View every state and territory as a table
59121 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 59121 in every payment locality

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

Office or facility?

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.

The exact Virginia inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,643

Code
59121
Physician work
12.42
Practice expense
5.61
Malpractice
3.98

GPCI2026.csv

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Facility calculation for 59121 in Virginia
ComponentRVULocality factorAdjusted
Physician work12.42× 1.00012.4200
Practice expense5.61× 0.9835.5146
Malpractice3.98× 0.7062.8099
Total RVUs20.7445
Conversion factor× 33.4009

Facility rate, Virginia$692.89

Facility: (12.42 × 1 + 5.61 × 0.983 + 3.98 × 0.706) × $33.4009 = $692.89

Open 59121 in the RVU calculator

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

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are 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)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.17/0.60/0.23Share 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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

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%).

When to use modifier 51

How 59121 has changed in Virginia

59121 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$692.89RVU26D
2026-07-01Not available in this setting$692.89RVU26C
2026-04-01Not available in this setting$692.89RVU26B
2026-01-01Not available in this setting$692.89RVU26A
2025-10-01Not available in this setting$764.68RVU25D
2025-07-01Not available in this setting$764.68RVU25C
2025-04-01Not available in this setting$764.68RVU25B
2025-01-01Not available in this setting$764.68RVU25A
2024-10-01Not available in this setting$789.24RVU24D
2024-07-01Not available in this setting$789.24RVU24C
2024-04-01Not available in this setting$789.24RVU24B
2024-03-09Not available in this setting$789.24RVU24AR
2024-01-01Not available in this setting$776.36RVU24A
2023-10-01Not available in this setting$809.27RVU23D
2023-07-01Not available in this setting$809.27RVU23C
2023-04-01Not available in this setting$809.27RVU23B
2023-01-01Not available in this setting$809.27RVU23A
2022-10-01Not available in this setting$828.21RVU22D
2022-07-01Not available in this setting$828.21RVU22C
2022-04-01Not available in this setting$828.21RVU22B
2022-01-01Not available in this setting$828.21RVU22A
2021-10-01Not available in this setting$824.75RVU21D
2021-07-01Not available in this setting$824.75RVU21C
2021-04-01Not available in this setting$824.75RVU21B
2021-01-01Not available in this setting$824.75RVU21A
2020-10-01Not available in this setting$834.18RVU20D
2020-07-01Not available in this setting$834.18RVU20C
2020-04-01Not available in this setting$834.18RVU20B
2020-01-01Not available in this setting$834.18RVU20A
2019-10-01Not available in this setting$816.96RVU19D
2019-07-01Not available in this setting$816.96RVU19C
2019-04-01Not available in this setting$816.96RVU19B
2019-01-01Not available in this setting$816.96RVU19A
2018-10-01Not available in this setting$808.72RVU18D
2018-07-01Not available in this setting$808.72RVU18C
2018-04-01Not available in this setting$808.72RVU18B
2018-01-01Not available in this setting$808.72RVU18AR1
2017-10-01Not available in this setting$803.98RVU17D
2017-07-01Not available in this setting$803.98RVU17C
2017-04-01Not available in this setting$803.98RVU17B
2017-01-01Not available in this setting$803.98RVU17A
2016-10-01Not available in this setting$797.47RVU16D
2016-07-01Not available in this setting$797.47RVU16C
2016-04-01Not available in this setting$797.47RVU16B
2016-01-01Not available in this setting$797.47RVU16A
2015-10-01Not available in this setting$802.42RVU15D
2015-07-01Not available in this setting$802.42RVU15C
2015-04-01Not available in this setting$798.43RVU15B
2015-01-01Not available in this setting$798.43RVU15A
2014-10-01Not available in this setting$798.55RVU14D
2014-07-01Not available in this setting$798.55RVU14C
2014-04-01Not available in this setting$798.55RVU14B
2014-01-01Not available in this setting$798.55RVU14A
2013-10-01Not available in this setting$776.69RVU13D
2013-07-01Not available in this setting$776.69RVU13C
2013-04-01Not available in this setting$776.69RVU13B
2013-01-01Not available in this setting$776.69RVU13AR

Price 59121 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

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

Show the CMS file lines behind this rate
RVUs for 59121PPRRVU2026_Oct_nonQPP.csv, line 6,643 (RVU26D)
Geographic factors for VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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