Billing code 59821: Miscarriage treatmentMedicare rate & RVUs
Report this service for surgical evacuation of a second-trimester pregnancy that has ended but remains in the uterus without expulsion.
Medicare pays $427.53 for 59821 nationally in the office and $344.03 in a hospital or facility. Local office rates run $372.34–$523.10.
Medicare rate · 59821
Miscarriage treatment
Swap in your local Medicare rate.
- Work RVUs
- 4.96
- Total RVUs
- 12.80
- Global days
- 090
National rate · 2026
$427.53
Office setting, before claim adjustments.
See every locality for 59821 → · 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.
On this page 10 sections
What 59821 covers
An obstetrician-gynecologist typically performs this procedure in a hospital or other surgical facility when a second-trimester pregnancy has ended and the pregnancy tissue remains in the uterus. The clinician surgically evacuates the retained tissue; the service is distinct from managing a miscarriage that is already incomplete and from ending an ongoing pregnancy by choice.
Select the code when the record supports fetal demise, second-trimester status, retained pregnancy tissue, and surgical management. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. If multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is not appropriate. Assistant-at-surgery payment requires documented medical necessity; 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 59821 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
$372.34 to $523.10
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $378.39 | $305.32 |
| Alaska* | $500.09 | $411.16 |
| Arizona | $413.41 | $332.50 |
| Arkansas | $372.34 | $300.61 |
| Atlanta | $442.04 | $357.20 |
| Austin | $433.92 | $345.57 |
| Bakersfield | $429.95 | $338.44 |
| Baltimore/Surr. Cntys | $458.01 | $368.41 |
| Beaumont | $404.97 | $328.99 |
| Brazoria | $415.29 | $332.54 |
| Chicago | $498.51 | $414.59 |
| Chico | $425.75 | $334.23 |
| Colorado | $431.25 | $342.40 |
| Connecticut | $458.07 | $368.14 |
| Dallas | $420.65 | $337.48 |
| Dc + Md/Va Suburbs | $479.64 | $381.27 |
| Delaware | $420.49 | $337.99 |
| Detroit | $456.66 | $376.08 |
| East St. Louis | $464.68 | $387.86 |
| El Centro | $426.01 | $334.49 |
| Fort Lauderdale | $473.16 | $388.57 |
| Fort Worth | $419.25 | $336.92 |
| Fresno | $425.75 | $334.23 |
| Galveston | $418.26 | $335.34 |
| Hanford-Corcoran | $425.75 | $334.23 |
| Hawaii, Guam | $433.77 | $338.83 |
| Houston | $447.36 | $364.45 |
| Idaho | $382.84 | $306.02 |
| Indiana | $385.00 | $307.59 |
| Iowa | $377.76 | $301.36 |
| Kansas | $381.15 | $305.66 |
| Kentucky | $399.85 | $325.61 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $454.68 | $355.90 |
| Madera | $425.75 | $334.23 |
| Manhattan | $503.07 | $406.04 |
| Merced | $425.75 | $334.23 |
| Metropolitan Boston | $468.98 | $369.28 |
| Metropolitan Kansas City | $413.58 | $335.17 |
| Metropolitan Philadelphia | $449.32 | $362.40 |
| Metropolitan St. Louis | $417.62 | $338.12 |
| Miami | $517.29 | $430.37 |
| Minnesota | $396.20 | $310.27 |
| Mississippi | $384.65 | $312.76 |
| Modesto | $425.75 | $334.23 |
| Montana** | $427.43 | $343.92 |
| Napa | $478.22 | $368.17 |
| Nebraska | $378.42 | $301.35 |
| Nevada** | $418.87 | $335.29 |
| New Hampshire | $429.45 | $342.53 |
| New Mexico | $420.88 | $344.31 |
| New Orleans | $422.44 | $343.86 |
| North Carolina | $394.37 | $316.47 |
| North Dakota** | $395.99 | $312.48 |
| Northern Nj | $474.98 | $378.12 |
| Nyc Suburbs/Long Island | $523.10 | $423.82 |
| Ohio | $409.79 | $333.56 |
| Oklahoma | $393.35 | $318.78 |
| Oxnard-Thousand Oaks-Ventura | $450.14 | $351.44 |
| Portland | $439.76 | $346.99 |
| Poughkpsie/N Nyc Suburbs | $465.97 | $374.54 |
| Puerto Rico | $429.03 | $344.61 |
| Queens | $499.60 | $400.90 |
| Redding | $425.75 | $334.23 |
| Rest Of California | $425.75 | $334.23 |
| Rest Of Florida | $445.06 | $365.23 |
| Rest Of Georgia | $415.18 | $340.70 |
| Rest Of Illinois | $439.27 | $363.03 |
| Rest Of Louisiana | $401.29 | $327.39 |
| Rest Of Maine | $390.76 | $313.93 |
| Rest Of Maryland | $427.34 | $342.83 |
| Rest Of Massachusetts | $430.47 | $342.54 |
| Rest Of Michigan | $416.22 | $339.98 |
| Rest Of Missouri | $397.34 | $325.36 |
| Rest Of New Jersey | $458.52 | $367.33 |
| Rest Of New York | $401.32 | $321.99 |
| Rest Of Oregon | $410.92 | $327.76 |
| Rest Of Pennsylvania | $407.49 | $330.84 |
| Rest Of Texas | $411.73 | $332.49 |
| Rest Of Washington | $428.06 | $340.13 |
| Rhode Island | $431.83 | $345.57 |
| Riverside-San Bernardino-Ontario | $442.75 | $351.23 |
| Sacramento-Roseville-Folsom | $442.88 | $345.77 |
| Salinas | $441.22 | $344.44 |
| San Diego-Chula Vista-Carlsbad | $449.09 | $349.23 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $500.13 | $382.39 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $498.32 | $380.58 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $513.38 | $392.97 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $506.00 | $385.59 |
| San Luis Obispo-Paso Robles | $434.72 | $339.61 |
| Santa Cruz-Watsonville | $451.25 | $349.80 |
| Santa Maria-Santa Barbara | $442.18 | $344.82 |
| Santa Rosa-Petaluma | $455.46 | $352.92 |
| Seattle (King Cnty) | $473.48 | $371.03 |
| South Carolina | $403.70 | $326.54 |
| South Dakota** | $392.27 | $308.77 |
| Southern Maine | $406.06 | $323.31 |
| Stockton | $425.75 | $334.23 |
| Suburban Chicago | $475.33 | $389.57 |
| Tennessee | $383.95 | $308.04 |
| Utah | $409.59 | $331.10 |
| Vallejo | $475.62 | $365.57 |
| Vermont | $399.21 | $316.54 |
| Virgin Islands | $429.03 | $344.61 |
| Virginia | $408.37 | $326.29 |
| Visalia | $425.75 | $334.23 |
| West Virginia | $423.07 | $350.51 |
| Wisconsin | $382.01 | $302.02 |
| Wyoming** | $413.72 | $330.22 |
| Yuba City | $425.75 | $334.23 |
59821 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.
$372.34
$500.09
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 | $500.09 | 1 |
| AL | $378.39 | 1 |
| AR | $372.34 | 1 |
| AZ | $413.41 | 1 |
| CA | $425.75–$513.38 | 29 |
| CO | $431.25 | 1 |
| CT | $458.07 | 1 |
| DC | $479.64 | 1 |
| DE | $420.49 | 1 |
| FL | $445.06–$517.29 | 3 |
| GA | $415.18–$442.04 | 2 |
| GU | $433.77 | 1 |
| HI | $433.77 | 1 |
| IA | $377.76 | 1 |
| ID | $382.84 | 1 |
| IL | $439.27–$498.51 | 4 |
| IN | $385.00 | 1 |
| KS | $381.15 | 1 |
| KY | $399.85 | 1 |
| LA | $401.29–$422.44 | 2 |
| MA | $430.47–$468.98 | 2 |
| MD | $427.34–$479.64 | 3 |
| ME | $390.76–$406.06 | 2 |
| MI | $416.22–$456.66 | 2 |
| MN | $396.20 | 1 |
| MO | $397.34–$417.62 | 3 |
| MS | $384.65 | 1 |
| MT | $427.43 | 1 |
| NC | $394.37 | 1 |
| ND | $395.99 | 1 |
| NE | $378.42 | 1 |
| NH | $429.45 | 1 |
| NJ | $458.52–$474.98 | 2 |
| NM | $420.88 | 1 |
| NV | $418.87 | 1 |
| NY | $401.32–$523.10 | 5 |
| OH | $409.79 | 1 |
| OK | $393.35 | 1 |
| OR | $410.92–$439.76 | 2 |
| PA | $407.49–$449.32 | 2 |
| PR | $429.03 | 1 |
| RI | $431.83 | 1 |
| SC | $403.70 | 1 |
| SD | $392.27 | 1 |
| TN | $383.95 | 1 |
| TX | $404.97–$447.36 | 8 |
| UT | $409.59 | 1 |
| VA | $408.37–$479.64 | 2 |
| VI | $429.03 | 1 |
| VT | $399.21 | 1 |
| WA | $428.06–$473.48 | 2 |
| WI | $382.01 | 1 |
| WV | $423.07 | 1 |
| WY | $413.72 | 1 |
How the 59821 rate is calculated
Each of 59821’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 · 59821
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.96Practice expense 6.25Malpractice 1.59
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 59821
59821 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 59821
Miscarriage treatment
| 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 59821
Miscarriage treatment
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
59821 without 51 · national office
$427.53
Miscarriage treatment
59821-51 · Second procedure: 50%
$213.77
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%).
59821 compared with similar codes
Compare codes
59821 vs 59820 vs 59812 vs 59841: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 59820Miscarriage care
- Use 59820 for surgical management of a missed miscarriage in the first trimester; use 59821 for the second trimester.
- 59812Miscarriage treatment
- 59812 describes surgical management of an incomplete miscarriage. 59821 is for a missed miscarriage with retained pregnancy tissue in the second trimester.
- 59841Induced abortion dilat&evac
- 59841 is for induced abortion by dilation and evacuation. 59821 treats a pregnancy that has ended spontaneously and remains in the uterus.
59821 billing questions
How does this differ from 59820?
Both address surgical management of a missed miscarriage, but 59821 is for the second trimester; 59820 is the first-trimester sibling.
When would 59812 be more appropriate?
Use 59812 for surgical treatment of an incomplete miscarriage, rather than a missed miscarriage with retained pregnancy tissue.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this service.
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 surgeon be reported?
Assistant-at-surgery payment is allowed only when the record documents medical necessity. Co-surgeons and team surgery are not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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
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