CPT 59000 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures for Maternity Care and Delivery |
| Common Place of Service | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • AG - Primary physician |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 59000 |
National average reimbursement for CPT 59000 by major payers:

$151.93

$164.30

$169.74

$199.30
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 59000 | ||||||
United | 59000 | $160.03 | 1417488164 - JAWAIRIA KHAN | 204923281 - MEMORIAL HERMANN MEDICAL GROUP | TX | Hospitalist Physician (208M00000X) |
United | 59000 | $295.77 | 1275695603 - MICHEL MAKHLOUF | 330672915 - FACULTY PHYSICIANS AND SURGEONS OF LLUSM | CA | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 59000 | $160.03 | 1336594878 - CHRISTOPHER LEVERT | 204923281 - MEMORIAL HERMANN MEDICAL GROUP | TX | Internal Medicine Physician (207R00000X) |
United | 59000 | $1708.00 | 1285283432 - JONESBORO AMBULATORY SURGERY CENTER, LLC | 832479059 - (AR) JONESBORO AMBULATORY SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59000 | $181.25 | 1750724399 - TU MAI | 760459500 - U T PHYSICIANS | TX | Pediatric Gastroenterology Physician (2080P0206X) |
United | 59000 | $211.67 | 1386724649 - ALBERT HERGENROEDER | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Pediatric Sports Medicine Physician (2080S0010X) |
United | 59000 | $181.25 | 1144208737 - ANTHONY JOHNSON | 760459500 - U T PHYSICIANS | TX | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 59000 | $259.98 | 1356617435 - LISETTE TANNER | 581537752 - EMORY UNIVERSITY | GA | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 59000 | $420.00 | 1679656714 - LITTLETON DAY SURGERY CENTER LLC | 232731319 - (CO) LITTLETON DAY SURGERY CENTER | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59000 | $404.00 | 1962580266 - NOVAMED SURGERY CENTER OF WARRENSBURG LLC, EYE SURGERY CENTER OF WARRENSBURG | 205698307 - (MO) NOVAMED SURGERY CENTER OF WARRENSBURG LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59000 | $117.59 | 1740830520 - CANDICE POLOCHAK ARRAMBIDE | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Family Nurse Practitioner (363LF0000X) |
United | 59000 | $175.52 | 1285096271 - MICHAEL LOPEZ | 760459500 - U T PHYSICIANS | TX | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician (208G00000X) |
United | 59000 | $122.22 | 1801552401 - PHYLICIA WILLIAMS | 204923281 - MEMORIAL HERMANN MEDICAL GROUP | TX | Acute Care Nurse Practitioner (363LA2100X) |
United | 59000 | $358.00 | 1801993217 - EYE PHYSICIANS OF SUSSEX COUNTY, EYE PHYSICIANS OF SUSSEX COUNTY SURGICAL SUITE | 222172159 - (NJ) EYE PHYSICIANS OF SUSSEX COUNTY | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59000 | $118.72 | 1871123026 - CHIOMA IKE | 204923281 - MEMORIAL HERMANN MEDICAL GROUP | TX | Family Nurse Practitioner (363LF0000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 59000 vs. Other Surgical Procedures for Maternity Care and Delivery Codes
The CPT 59000 code is part of the Surgery services used for Surgical Procedures for Maternity Care and Delivery. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 59000 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 59000. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 59000 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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