No office rate
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.
On this page
CMS RVU26D · Effective 2026-10-01
59121 Ectopic surgery Medicare reimbursement rates
Reports open abdominal surgery for a tubal or ovarian ectopic pregnancy when the pregnancy is treated without removing the affected tube or ovary. Compare 59121 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 59121?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 59121 pays more and less
Gynecologic surgery
About 59121: Open ectopic pregnancy treatment with organ preservation
Reports open abdominal surgery for a tubal or ovarian ectopic pregnancy when the pregnancy is treated without removing the affected tube or ovary.
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.
CMS billing rules for 59121
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU12.42 · 56%
- Practice expense (office) RVU5.61 · 25%
- Malpractice RVU3.98 · 18%
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.
59121 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
59150 is the laparoscopic counterpart when the tube and ovary are preserved. 59121 describes open abdominal treatment.
No office rate
59151 describes laparoscopic treatment with salpingectomy and/or oophorectomy; 59121 is open treatment without removal of the affected tube or ovary.
No office rate
59130 addresses an abdominal ectopic pregnancy. 59121 is for a tubal or ovarian ectopic pregnancy treated through an open abdominal approach.
See how rates vary across the country
59121 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 59121 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $654.04 |
| Alaska* | Office Unavailable | Facility $895.06 |
| Arizona | Office Unavailable | Facility $710.20 |
| Arkansas | Office Unavailable | Facility $644.26 |
| Atlanta | Office Unavailable | Facility $766.12 |
| Austin | Office Unavailable | Facility $731.70 |
| Bakersfield | Office Unavailable | Facility $709.05 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $786.98 |
| Beaumont | Office Unavailable | Facility $708.85 |
| Brazoria | Office Unavailable | Facility $707.54 |
| Chicago | Office Unavailable | Facility $911.15 |
| Chico | Office Unavailable | Facility $698.51 |
| Colorado | Office Unavailable | Facility $723.01 |
| Connecticut | Office Unavailable | Facility $785.80 |
| Dallas | Office Unavailable | Facility $719.26 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $805.93 |
| Delaware | Office Unavailable | Facility $721.55 |
| Detroit | Office Unavailable | Facility $819.79 |
| East St. Louis | Office Unavailable | Facility $854.96 |
| El Centro | Office Unavailable | Facility $699.18 |
| Fort Lauderdale | Office Unavailable | Facility $845.00 |
| Fort Worth | Office Unavailable | Facility $719.12 |
| Fresno | Office Unavailable | Facility $698.51 |
| Galveston | Office Unavailable | Facility $714.30 |
| Hanford-Corcoran | Office Unavailable | Facility $698.51 |
| Hawaii, Guam | Office Unavailable | Facility $704.86 |
| Houston | Office Unavailable | Facility $787.14 |
| Idaho | Office Unavailable | Facility $650.11 |
| Indiana | Office Unavailable | Facility $653.15 |
| Iowa | Office Unavailable | Facility $639.07 |
| Kansas | Office Unavailable | Facility $651.23 |
| Kentucky | Office Unavailable | Facility $703.06 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $741.79 |
| Madera | Office Unavailable | Facility $698.51 |
| Manhattan | Office Unavailable | Facility $869.96 |
| Merced | Office Unavailable | Facility $698.51 |
| Metropolitan Boston | Office Unavailable | Facility $773.89 |
| Metropolitan Kansas City | Office Unavailable | Facility $720.67 |
| Metropolitan Philadelphia | Office Unavailable | Facility $775.96 |
| Metropolitan St. Louis | Office Unavailable | Facility $726.43 |
| Miami | Office Unavailable | Facility $946.09 |
| Minnesota | Office Unavailable | Facility $647.00 |
| Mississippi | Office Unavailable | Facility $674.41 |
| Modesto | Office Unavailable | Facility $698.51 |
| Montana** | Office Unavailable | Facility $734.89 |
| Napa | Office Unavailable | Facility $755.47 |
| Nebraska | Office Unavailable | Facility $638.04 |
| Nevada** | Office Unavailable | Facility $713.14 |
| New Hampshire | Office Unavailable | Facility $726.22 |
| New Mexico | Office Unavailable | Facility $746.32 |
| New Orleans | Office Unavailable | Facility $742.18 |
| North Carolina | Office Unavailable | Facility $674.61 |
| North Dakota** | Office Unavailable | Facility $656.19 |
| Northern Nj | Office Unavailable | Facility $800.31 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $911.04 |
| Ohio | Office Unavailable | Facility $719.92 |
| Oklahoma | Office Unavailable | Facility $685.46 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $730.76 |
| Portland | Office Unavailable | Facility $728.56 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $799.54 |
| Puerto Rico | Office Unavailable | Facility $735.22 |
| Queens | Office Unavailable | Facility $854.56 |
| Redding | Office Unavailable | Facility $698.51 |
| Rest Of California | Office Unavailable | Facility $698.51 |
| Rest Of Florida | Office Unavailable | Facility $793.78 |
| Rest Of Georgia | Office Unavailable | Facility $740.44 |
| Rest Of Illinois | Office Unavailable | Facility $793.69 |
| Rest Of Louisiana | Office Unavailable | Facility $708.02 |
| Rest Of Maine | Office Unavailable | Facility $669.91 |
| Rest Of Maryland | Office Unavailable | Facility $730.65 |
| Rest Of Massachusetts | Office Unavailable | Facility $724.74 |
| Rest Of Michigan | Office Unavailable | Facility $736.00 |
| Rest Of Missouri | Office Unavailable | Facility $705.84 |
| Rest Of New Jersey | Office Unavailable | Facility $781.88 |
| Rest Of New York | Office Unavailable | Facility $686.30 |
| Rest Of Oregon | Office Unavailable | Facility $694.92 |
| Rest Of Pennsylvania | Office Unavailable | Facility $712.48 |
| Rest Of Texas | Office Unavailable | Facility $712.70 |
| Rest Of Washington | Office Unavailable | Facility $718.71 |
| Rhode Island | Office Unavailable | Facility $734.86 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $741.07 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $718.95 |
| Salinas | Office Unavailable | Facility $716.12 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $723.44 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $779.47 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $774.95 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $801.93 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $783.45 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $706.57 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $722.47 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $716.19 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $728.64 |
| Seattle (King Cnty) | Office Unavailable | Facility $774.10 |
| South Carolina | Office Unavailable | Facility $700.97 |
| South Dakota** | Office Unavailable | Facility $646.88 |
| Southern Maine | Office Unavailable | Facility $684.41 |
| Stockton | Office Unavailable | Facility $698.51 |
| Suburban Chicago | Office Unavailable | Facility $845.74 |
| Tennessee | Office Unavailable | Facility $656.55 |
| Utah | Office Unavailable | Facility $710.35 |
| Vallejo | Office Unavailable | Facility $748.96 |
| Vermont | Office Unavailable | Facility $667.61 |
| Virgin Islands | Office Unavailable | Facility $735.22 |
| Virginia | Office Unavailable | Facility $692.89 |
| Visalia | Office Unavailable | Facility $698.51 |
| West Virginia | Office Unavailable | Facility $767.90 |
| Wisconsin | Office Unavailable | Facility $635.29 |
| Wyoming** | Office Unavailable | Facility $700.59 |
| Yuba City | Office Unavailable | Facility $698.51 |
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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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
6,64059076,,Fetal shunt placement w/us,A,,8.77,2.28,NA,2.28,,2.81,13.86,13.86,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,64159100,,Remove uterus lesion,A,,13.04,5.85,NA,5.85,,4.18,23.07,23.07,0,090,0.17,0.60,0.23,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,64259120,,Treat ectopic pregnancy,A,,12.35,5.70,NA,5.70,,3.95,22.00,22.00,0,090,0.17,0.60,0.23,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,64359121,,Treat ectopic pregnancy,A,,12.42,5.61,NA,5.61,,3.98,22.01,22.01,0,090,0.17,0.60,0.23,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,64459130,,Treat ectopic pregnancy,A,,14.70,6.10,NA,6.10,,4.72,25.52,25.52,0,090,0.17,0.60,0.23,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,64559136,,Treat ectopic pregnancy,A,,13.89,5.84,NA,5.84,,4.46,24.19,24.19,0,090,0.17,0.60,0.23,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,64659140,,Treat ectopic pregnancy,A,,5.79,3.74,NA,3.74,,1.85,11.38,11.38,0,090,0.17,0.60,0.23,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00