Billing code 59000: AmniocentesisMedicare rate & RVUs in Georgia

Percutaneous amniotic fluid collection for prenatal diagnostic testing, such as evaluation of fetal chromosomes, genetic conditions, or infection.

CMS RVU26DEffective Oct 1, 20262 payment localities59 Medicare services in 2024

Medicare pays $115.35–$123.47 for 59000 in the office in Georgia, from Rest Of Georgia to Atlanta. Which amount applies depends on the service address.

$115.35–$123.47Office (non-facility)
$73.64–$75.96Hospital or facility

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 59000 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Georgia
  2. What 59000 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 59000 covers

An obstetrician or maternal-fetal medicine specialist uses a needle passed through the maternal abdomen and uterine wall to collect amniotic fluid. Ultrasound commonly helps locate the fluid pocket and avoid the fetus and placenta. The sample is sent for diagnostic laboratory testing, such as chromosome or genetic analysis or evaluation for fetal infection. The procedure is performed in an office or facility setting where prenatal diagnostic sampling is provided.

Report 59000 for diagnostic fluid collection, not for fluid removal intended to treat a condition. The record should identify the diagnostic indication, the sampling procedure, and the specimen obtained; laboratory analysis is separately represented. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; 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 59000 pays more and less in Georgia

59000 office and facility rates by payment locality
Payment localityOfficeFacility
Atlanta$123.47$75.96
Rest Of Georgia$115.35$73.64

How the 59000 rate is calculated

Each of 59000’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 · 59000

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 1.27Practice expense 1.90Malpractice 0.41

3.5800 adjusted RVUs×$33.4009 conversion factor=$119.58

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 59000

The CMS indicators that decide how 59000 is paid alongside other services.

CMS payment indicators · 59000

Amniocentesis

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)1Not paid (statutory restriction).
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

59000 without 51 · national office

$119.58

Amniocentesis

59000-51 · Second procedure: 50%

$59.79

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

59000 compared with similar codes

Compare codes

59000 vs 59001 vs 59015 vs 59012 vs 76946: national Medicare rates

Swap in your local Medicare rate.

  • 59000
    Amniocentesis · 1.27 wRVU
    $119.58
  • 59001
    Amniocentesis · 2.93 wRVU
    —
  • 59015
    Chorionic villus sampling · 2.15 wRVU
    $160.66+$41.08
  • 59012
    Cordocentesis · 3.35 wRVU
    —
  • 76946
    Amniocentesis guidance · 0.37 wRVU
    $34.07−$85.51

How to choose

59001Amniocentesis
Choose 59000 when amniotic fluid is collected for diagnostic testing; 59001 is for therapeutic fluid removal.
59015Chorionic villus sampling
59015 represents chorionic tissue sampling for prenatal diagnosis; 59000 obtains amniotic fluid.
59012Cordocentesis
59012 represents prenatal fetal cord puncture for blood sampling, not collection of amniotic fluid.
76946Amniocentesis guidance
76946 represents ultrasound guidance and its imaging supervision and interpretation; 59000 represents the diagnostic fluid collection.

59000 billing questions

How does 59000 differ from therapeutic amniocentesis?

Use 59000 when fluid is collected for diagnosis. Code 59001 describes amniotic fluid removal for a therapeutic purpose.

Is ultrasound guidance included in 59000?

Ultrasound is commonly used to guide needle placement. When guidance is performed and documented, 76946 may be reported separately, subject to applicable coding edits.

Can modifier 50 be used for sampling from both sides?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for 59000. Co-surgeons and team surgery are not permitted.

What documentation supports reporting 59000?

Document the diagnostic reason for sampling, the amniocentesis performed, and the fluid specimen obtained. Keep the diagnostic purpose distinct from therapeutic fluid removal.

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 59000PPRRVU2026_Oct_nonQPP.csv, line 6,624 (RVU26D)

Open CMS sourceHow we calculate rates

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