No office rate
Choose 59000 when amniotic fluid is collected for diagnostic testing; 59001 is for therapeutic fluid removal.
On this page
CMS RVU26D · Effective 2026-10-01
59000 Amniocentesis Medicare reimbursement rates in Wisconsin
Percutaneous amniotic fluid collection for prenatal diagnostic testing, such as evaluation of fetal chromosomes, genetic conditions, or infection. Compare 59000 office and facility rates across CMS payment localities in Wisconsin.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 59000 in Wisconsin?
Wisconsin has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$107.43
1 of 1 localities have a supported rate.
Payment area: Wisconsin
One mapped payment locality.
Facility setting
$62.64
1 of 1 localities have a supported rate.
Payment area: Wisconsin
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Obstetrics procedure
About 59000: Diagnostic amniotic fluid aspiration
Percutaneous amniotic fluid collection for prenatal diagnostic testing, such as evaluation of fetal chromosomes, genetic conditions, or infection.
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.
CMS billing rules for 59000
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.27 · 35%
- Practice expense (office) RVU1.90 · 53%
- Malpractice RVU0.41 · 11%
59
Medicare services in 2024 · #5259 by national volume
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.
59000 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
$142.16
59015 represents chorionic tissue sampling for prenatal diagnosis; 59000 obtains amniotic fluid.
No office rate
59012 represents prenatal fetal cord puncture for blood sampling, not collection of amniotic fluid.
$32.51
76946 represents ultrasound guidance and its imaging supervision and interpretation; 59000 represents the diagnostic fluid collection.
Compare 59000 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Wisconsin →
Office / nonfacility
$107.43
Facility
$62.64
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 59000 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
6,624
- Code
- 59000
- Physician work
- 1.27
- Practice expense
- 1.90
- Malpractice
- 0.41
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.27 | × 1.000 | 1.2700 |
| Practice expense | 1.90 | × 0.958 | 1.8202 |
| Malpractice | 0.41 | × 0.308 | 0.1263 |
| Total RVUs | 3.2165 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wisconsin$107.43
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.27 | 1 |
| Practice expense | 1.9 | 0.958 |
| Malpractice | 0.41 | 0.308 |
(1.27 × 1 + 1.9 × 0.958 + 0.41 × 0.308) × $33.4009 = $107.43
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.27 | 1 |
| Practice expense | 0.5 | 0.958 |
| Malpractice | 0.41 | 0.308 |
(1.27 × 1 + 0.5 × 0.958 + 0.41 × 0.308) × $33.4009 = $62.64
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
6,62158974,,Embryo transfer intrauterine,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,62258976,,Transfer of embryo,A,,3.72,3.27,,1.21,,0.65,7.64,5.58,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,62358999,,Unlisted px fml genital sys,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,1,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
6,62459000,,Amniocentesis diagnostic,A,,1.27,1.90,,0.50,,0.41,3.58,2.18,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,62559001,,Amniocentesis therapeutic,A,,2.93,0.92,NA,0.92,,0.93,4.78,4.78,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,62659012,,Fetal cord puncture prenatal,A,,3.35,0.95,NA,0.95,,1.08,5.38,5.38,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,62759015,,Chorion biopsy,A,,2.15,1.98,,0.69,,0.68,4.81,3.52,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,