CPT 59012 Surgery - Maternity

How Much Does Amniocentesis (Amniotic Fluid Test) Cost?

Also known as: Fetal cord puncture prenatal (CPT 59012)

A procedure where a small amount of amniotic fluid is removed from around the baby for genetic or health testing.

Amniocentesis (Amniotic Fluid Test) (CPT 59012) costs $180 at Medicare rates. Hospital outpatient rate: $311.

Cost Comparison by Payer

How much Fetal cord puncture prenatal costs across different settings and payers

Medicare
Facility rate
$180
Hospital Outpatient
OPPS rate
$311
Surgery Center
ASC rate
$167
Medicare (Facility)
$180
CMS PFS 2026 national rate
Hospital Outpatient
$311
OPPS rate
Surgery Center (ASC)
$167
Ambulatory surgery center

Patient Guide: Amniocentesis (Amniotic Fluid Test)

What you need to know before your appointment

What to Expect

Using ultrasound guidance, the doctor inserts a thin needle through your belly into the amniotic sac and withdraws a small amount of fluid. Most women feel pressure and mild cramping.

How Long Does It Take?

15-30 minutes

Common Reasons Doctors Order This

Genetic testing, chromosomal abnormality screening, lung maturity testing, infection evaluation

How to Prepare

Arrange a ride home. Plan to rest for the remainder of the day. Follow all pre-procedure instructions from your doctor.

Procedures Commonly Done Together

These procedures are frequently performed alongside Fetal cord puncture prenatal

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How to Reduce Your Cost for Fetal cord puncture prenatal

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

  • 4
    Check ambulatory surgery centers (ASCs)

    This procedure is available at ASCs for $167, compared to $311 at hospital outpatient departments. ASCs often offer lower costs with comparable quality.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

3.35
Work RVU
0.95
Practice Expense RVU
1.08
Malpractice RVU
5.38
Total RVU

Payment = Total RVU (5.38) x CF ($33.40) = $180

Frequently Asked Questions

How much does Fetal cord puncture prenatal cost?

The Medicare facility rate for Fetal cord puncture prenatal is $180. In a hospital outpatient setting, the rate is $311. At an ambulatory surgery center, the rate is $167. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Fetal cord puncture prenatal cost without insurance?

Without insurance, the cost of Fetal cord puncture prenatal can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Fetal cord puncture prenatal?

Most commercial health insurance plans and Medicare cover Fetal cord puncture prenatal when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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