Billing code 59076: Fetal shuntMedicare rate & RVUs in Guam
Report this service for ultrasound-guided placement of a shunt that redirects fluid from a fetal body space into the amniotic cavity.
CMS doesn’t publish an office rate for 59076 in Guam.
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 59076 covers
A maternal-fetal medicine specialist or other qualified fetal interventionist places a shunt through the maternal abdomen and uterus into a fetal fluid space, positioning it to drain into the amniotic cavity. Examples include a pleuroamniotic shunt for fetal hydrothorax or a vesicoamniotic shunt for obstructive urinary tract disease. The service is performed under ultrasound guidance, commonly in a specialized fetal therapy setting.
Report the placement when a shunt is inserted; needle aspiration of fluid without shunt placement is a different service. Documentation should identify the fetal condition and target space, the shunt placement, and ultrasound guidance. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard multiple-procedure reduction. Modifier 50 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.
59076 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $433.86 |
How the 59076 rate is calculated
Each of 59076’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 · 59076
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.77Practice expense 2.28Malpractice 2.81
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 59076
The CMS indicators that decide how 59076 is paid alongside other services.
CMS payment indicators · 59076
Fetal shunt
| 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
59076 without 51 · national facility
$462.94
Fetal shunt
59076-51 · Second procedure: 50%
$231.47
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%).
59076 compared with similar codes
Compare codes
59076 vs 59074 vs 59070 vs 59072: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 59074Fetal fluid drainage
- Choose 59076 when a shunt is placed for ongoing drainage; 59074 describes fetal fluid drainage without shunt placement.
- 59070Amnioinfusion
- 59070 is used for ultrasound-guided transabdominal amnioinfusion. It adds fluid to the amniotic cavity rather than placing a fetal shunt.
- 59072Cord occlusion
- 59072 describes ultrasound-guided umbilical cord occlusion. It is a cord intervention, not placement of a shunt to drain a fetal body space.
59076 billing questions
How does this differ from fetal fluid drainage, 59074?
59076 is for placing a shunt to provide ongoing drainage. Use 59074 for fetal fluid drainage without shunt placement.
Can ultrasound guidance be reported separately?
Ultrasound guidance is part of the described shunt placement service. Document the imaging guidance used for the placement.
Should modifier 50 be appended for shunts on both sides?
No. Modifier 50 is inappropriate for this code.
What same-day care is included in the global period?
The 0-day global period includes same-day preoperative and postoperative care.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures are subject to the standard multiple-procedure reduction. An assistant at surgery may be paid, but co-surgeons and team surgery are 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
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