$107.43
Choose 59012 for fetal blood collected through the umbilical cord; choose 59000 when the prenatal specimen is amniotic fluid.
On this page
CMS RVU26D · Effective 2026-10-01
59012 Cordocentesis Medicare reimbursement rates in Wisconsin
Percutaneous fetal umbilical cord access to collect blood before birth, reported when direct fetal blood sampling is needed for prenatal evaluation. Compare 59012 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 59012 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
No supported rate
Facility setting
$153.40
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.
Obstetric procedure
About 59012: Prenatal fetal blood sampling
Percutaneous fetal umbilical cord access to collect blood before birth, reported when direct fetal blood sampling is needed for prenatal evaluation.
This service involves percutaneous access to the fetal umbilical cord before birth to collect a fetal blood specimen. It is typically performed by a maternal-fetal medicine specialist or obstetrician in a hospital or specialized prenatal procedure setting, with ultrasound localization. Cord blood may be sampled when direct evaluation is needed for concerns such as fetal anemia, alloimmunization, or fetal infection. The specimen source distinguishes this procedure from sampling amniotic fluid or placental villi, and from fetal scalp sampling during labor.
Report the service when the documented procedure includes cord puncture and fetal blood collection. The record should support the clinical indication, cord access, specimen collection, and resulting evaluation or plan. CMS assigns 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 the others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 59012
- 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.35 · 62%
- Practice expense (office) RVU0.95 · 18%
- Malpractice RVU1.08 · 20%
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.
59012 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
$142.16
59015 represents prenatal sampling of chorionic villi. 59012 is for blood obtained from the fetal umbilical cord.
No office rate
59030 involves fetal scalp blood sampling during labor. 59012 is prenatal sampling through the umbilical cord.
Compare 59012 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
Unavailable
Facility
$153.40
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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 59012 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
6,626
- Code
- 59012
- Physician work
- 3.35
- Practice expense
- 0.95
- Malpractice
- 1.08
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.35 | × 1.000 | 3.3500 |
| Practice expense | 0.95 | × 0.958 | 0.9101 |
| Malpractice | 1.08 | × 0.308 | 0.3326 |
| Total RVUs | 4.5927 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$153.40
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.35 | 1 |
| Practice expense | 0.95 | 0.958 |
| Malpractice | 1.08 | 0.308 |
(3.35 × 1 + 0.95 × 0.958 + 1.08 × 0.308) × $33.4009 = $153.40
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.
59012 billing questions
How is this different from amniocentesis?
59012 is selected when the specimen is obtained from the fetal umbilical cord. Amniocentesis obtains amniotic fluid instead.
Can ultrasound guidance be reported with this procedure?
Code 76946 describes ultrasound guidance for fetal cordocentesis. Report it when the guidance service is documented and separately reportable.
Does the 0-day global period include same-day care?
Yes. Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
Should modifier 50 be used for cord puncture?
No. CMS identifies bilateral adjustment as inappropriate for this code.
When can an assistant-at-surgery be paid?
Assistant-at-surgery payment is allowed only when medical necessity is documented. 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 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.
6,62358999,,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
6,62859020,,Fetal contract stress test,A,,0.64,1.35,,1.35,NA,0.19,2.18,2.18,1,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,62959020,26,Fetal contract stress test,A,,0.64,0.28,,0.28,,0.18,1.10,1.10,1,000,0.00,0.00,0.00,0,0,0,0,0,9,,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,,,,,,