Billing code 59074: Fetal fluid drainageMedicare rate & RVUs in Guam
Report this service for ultrasound-guided therapeutic drainage of a fetal fluid collection, such as pleural fluid or fetal ascites.
Medicare pays $387.91 for 59074 in the office in Guam (Hawaii, Guam). Which amount applies depends on the service address.
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 9 sections
What 59074 covers
This procedure drains fluid from a collection within the fetus, rather than removing amniotic fluid from the uterus. Examples include fetal thoracentesis for a pleural effusion and fetal paracentesis for ascites. A maternal-fetal medicine specialist or fetal therapy physician typically performs the intervention in a hospital setting, using ultrasound to guide access and monitor the fetus during drainage. Ultrasound guidance is part of the reported service.
Choose the code when the treatment is drainage of fetal fluid; document the collection’s location, the therapeutic reason, and the procedure performed. Distinguish this from therapeutic amniocentesis, which removes amniotic fluid. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others are subject to the standard multiple procedure reduction. Bilateral adjustment is inappropriate. An assistant at surgery may be paid; 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.
59074 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $387.91 | $259.55 |
How the 59074 rate is calculated
Each of 59074’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 · 59074
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.11Practice expense 4.89Malpractice 1.63
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 59074
The CMS indicators that decide how 59074 is paid alongside other services.
CMS payment indicators · 59074
Fetal fluid drainage
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
59074 without 51 · national office
$388.45
Fetal fluid drainage
59074-51 · Second procedure: 50%
$194.23
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%).
59074 compared with similar codes
Compare codes
59074 vs 59001 vs 59070 vs 59076 vs 59000: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 59001Amniocentesis
- 59074 drains fluid from within the fetus; 59001 removes excess fluid from the amniotic cavity.
- 59070Amnioinfusion
- 59074 drains a fetal fluid collection. 59070 infuses fluid into the amniotic cavity.
- 59076Fetal shunt
- 59074 drains a fetal fluid collection; 59076 places a shunt to divert fluid.
- 59000Amniocentesis
- 59000 is diagnostic amniocentesis for sampling amniotic fluid. 59074 is therapeutic drainage of fluid within the fetus.
59074 billing questions
When should this be reported instead of therapeutic amniocentesis?
Report 59074 for drainage of a fluid collection within the fetus, such as a pleural effusion or ascites. Therapeutic amniocentesis removes excess amniotic fluid from the amniotic cavity.
Is ultrasound guidance separately reported?
No. Ultrasound guidance is included in the fetal fluid drainage service.
What documentation supports reporting 59074?
Document the fetal fluid collection and its location, the clinical reason for drainage, and the drainage procedure performed. For example, identify a pleural effusion when performing fetal thoracentesis.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures performed in that session are paid at 50%.
Can an assistant, co-surgeon, or surgical team be reported?
An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted for this code.
Does the procedure have a postoperative global period?
It has a 0-day global period. Same-day preoperative and postoperative care is included.
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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