Billing code 59412: Fetal versionMedicare rate & RVUs in Texas
Report 59412 when an obstetric clinician manually turns a fetus through the maternal abdomen before delivery, with or without tocolysis.
CMS doesn’t publish an office rate for 59412 in Texas.
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 59412 covers
An external cephalic version uses pressure on the pregnant patient’s abdomen to turn a fetus from a non-cephalic position, such as breech or transverse, toward a head-down position. An obstetrician or other qualified maternity clinician typically performs it in a hospital labor-and-delivery unit, where fetal status can be monitored. The procedure may include medication to relax the uterus; the code covers the version whether or not tocolysis is used.
Select 59412 for the antepartum manipulation itself, not for routine prenatal visits or the eventual delivery. Documentation should identify the fetal presentation and clinical reason for the attempt, describe the manipulation and outcome, and record relevant fetal assessment and any tocolysis. CMS classifies this as a maternity code, so handle it under maternity billing rather than assigning a standard surgical global-period expectation. The code’s payment includes work, practice expense, and malpractice components in the physician fee schedule.
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 59412 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $93.35 |
| Beaumont | Unavailable | $91.20 |
| Brazoria | Unavailable | $90.51 |
| Dallas | Unavailable | $92.07 |
| Fort Worth | Unavailable | $92.11 |
| Galveston | Unavailable | $91.41 |
| Houston | Unavailable | $101.30 |
| Rest Of Texas | Unavailable | $91.47 |
How the 59412 rate is calculated
Each of 59412’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 · 59412
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.71Practice expense 0.57Malpractice 0.54
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 59412
The CMS indicators that decide how 59412 is paid alongside other services.
CMS payment indicators · 59412
Fetal version
| Rule | CMS value | What it means |
|---|---|---|
| Global period | MMM | Maternity care: global rules don’t follow the standard pattern. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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. |
59412 compared with similar codes
Compare codes
59412 vs 59400 vs 59425 vs 59426 vs 59409: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 59400Maternity care
- 59400 represents global obstetric care that includes delivery and postpartum care. 59412 describes the separate antepartum version maneuver.
- 59425Prenatal care
- 59425 represents antepartum care only for a limited number of visits; it does not describe turning the fetus.
- 59426Prenatal care
- 59426 represents antepartum care only for a larger visit-count range than 59425. Neither code represents an external version procedure.
- 59409Vaginal delivery
- 59409 describes vaginal delivery only. Use 59412 for the antepartum maneuver, even when a delivery occurs later.
59412 billing questions
When should 59412 be reported instead of an obstetric delivery code?
Use 59412 for the antepartum attempt to turn the fetus through the maternal abdomen. Report the appropriate delivery code for a subsequent delivery service.
Does 59412 include tocolysis?
Yes. The code covers the version with or without medication used to relax the uterus.
What documentation supports 59412?
Document the fetal presentation, reason for attempting version, manipulation performed, result, relevant fetal assessment, and whether tocolysis was used.
Is 59412 subject to a standard surgical global period?
CMS identifies it as a maternity code. Handle it under maternity billing rather than applying a standard surgical global-period expectation.
Can an ultrasound or fetal monitoring service be reported with 59412?
A separately performed and documented obstetric ultrasound or fetal monitoring service may be relevant to the same encounter. The record should support the distinct service rather than merely restating the version procedure.
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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