Billing code 59414: Placental deliveryMedicare rate & RVUs in Guam
Report separate placental delivery when the placenta requires a distinct service after fetal delivery, rather than as part of routine vaginal delivery care.
CMS doesn’t publish an office rate for 59414 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 59414 covers
billing code 59414 represents delivery of the placenta as a distinct obstetric service after the fetus has been delivered. A typical situation is a retained placenta requiring manual extraction after the birth; the service may be performed by the delivering obstetrician or another clinician responsible for completing placental delivery. It is most often encountered in a hospital or other labor-and-delivery setting.
Report the code only when the placental service is separate from the routine delivery service being billed. The record should establish that fetal delivery had occurred and describe the separate placental intervention, such as manual removal for retained placenta. When another procedure is performed in the same session, CMS applies the standard multiple procedure reduction: the highest-valued procedure is paid in full and other procedures are paid at 50%. The usual global surgery rules do not apply to this maternity code.
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.
59414 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $76.74 |
How the 59414 rate is calculated
Each of 59414’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 · 59414
RVUs × geographic indexes × conversion factor
Work1.61
1.61 RVUs× 1.000 GPCI
Practice expense0.35
0.35 RVUs× 1.000 GPCI
Malpractice0.50
0.50 RVUs× 1.000 GPCI
Adjusted RVUs
2.4600
Conversion factor
$33.4009
Medicare rate
$82.17
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 59414
The CMS indicators that decide how 59414 is paid alongside other services.
CMS payment indicators · 59414
Placental delivery
| Rule | CMS value | What it means |
|---|---|---|
| Global period | MMM | Maternity care: global rules don’t follow the standard pattern. |
| 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. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
59414 without 51 · national facility
$82.17
Placental delivery
59414-51 · Second procedure: 50%
$41.09
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%).
59414 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 59409Vaginal delivery
- 59409 reports vaginal fetal delivery. 59414 is for a distinct placental delivery service, not the routine third stage of a vaginal birth.
- 59410Vaginal delivery
- 59410 includes vaginal delivery and postpartum care. 59414 describes separate placental delivery and does not represent postpartum care.
- 59400Maternity care
- 59400 covers comprehensive maternity care, including vaginal delivery. 59414 is limited to a separate placental service and is not a substitute for comprehensive care.
59414 billing questions
When should 59414 be reported instead of 59409?
59409 represents vaginal delivery; routine placental delivery is part of that delivery service. Use 59414 for a distinct placental delivery service, such as separate removal of a retained placenta, rather than to unbundle routine completion of the birth.
Can 59414 be reported with a vaginal delivery code?
It may be appropriate when the placental service is genuinely separate from the fetal delivery service and the documentation supports both. The record should make clear what separate placental intervention was performed.
What documentation supports 59414?
Document that the fetus had been delivered, the placental problem or circumstance requiring separate service, and the clinician's actions to deliver or remove the placenta.
Does 59414 have the usual surgical global period?
No. CMS identifies 59414 as a maternity code for which the usual global surgery rules do not apply.
How does the multiple procedure reduction affect 59414?
When it is performed with another procedure in the same session, CMS pays the highest-valued procedure in full and the other procedure or procedures at 50%.
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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