CPT 59020 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 | • 21 - Inpatient Hospital • 11 - Office |
| Common Modifiers | • None • 26 - Professional component • 59 - Distinct Procedural Service |
| Complexity Level | Low |
National average reimbursement for CPT 59020 by major payers:

$87.62

$91.95

$89.12

$116.38
| 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 59020 | ||||||
United | 59020 | $60.00 | 1962455428 - VALLEY EYE INSTITUTE ASC LLC, CVP SURGERY CENTER | 200080762 - (OH) VALLEY EYE INSTITUTE ASC LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59020 | $1831.00 | 1760412803 - MEMORIAL HERMANN SURGERY CENTER KATY LLP | 203360737 - (TX) MEMORIAL HERMANN SURGERY CENTER KATY LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59020 | $410.00 | 1164414447 - EAST VALLEY ENDOSCOPY LLC | 870667809 - (AZ) EAST VALLEY ENDOSCOPY, PLLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59020 | $1500.00 | 1518057546 - LONG ISLAND AMBULATORY SURGERY CENTER, LLC | 200369668 - (NY) LONG ISLAND AMBULATORY SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59020 | $70.00 | 1316641236 - VENTURA ENDOSCOPY CENTER PARTNERS LLC | 922672667 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59020 | $200.00 | 1003036310 - MIDWEST ENDOSCOPY CENTER LLC | 208292570 - (IL) MIDWEST ENDOSCOPY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59020 | $405.00 | 1508862996 - PLASTIC SURGERY CENTER OF ST JOSEPH, INC | 200511264 - (MO) PLASTIC SURGERY CENTER OF ST JOSEPH INC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59020 | $90.00 | 1386792588 - WM DARRELL GASKINS LLC, NAPLES PREMIER SURGERY CENTER | 592484735 - (FL) WILLIAM DARRELL GASKINS, M.D. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59020 | $541.00 | 1588656508 - SAINT THOMAS CAMPUS SURGICARE LP | 752959131 - (TN) SAINT THOMAS CAMPUS SURGICARE LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59020 | $574.00 | 1912378357 - DAVENPORT AMBULATORY SURGERY CENTER, L.L.C. | 881811228 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59020 | $70.00 | 1710177795 - ASPEN SURGERY CENTER, LLC, ASPEN SURGERY CENTER | 205090169 - (CA) ASPEN SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59020 | $420.00 | 1467472688 - WEST CLINIC ASTC, WEST CLINIC, PC | 621526296 - THE WEST CLINIC, PLLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59020 | $109.00 | 1043497019 - PIKESVILLE MD ENDOSCOPY ASC LLC, ENDOCENTRE OF BALTIMORE | 261467040 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59020 | $555.00 | 1730175159 - CHARLOTTE ENDOSCOPIC SURGERY CENTER LLC, CHARLOTTE SURGERY CENTER | 651071112 - (FL) CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59020 | $68.00 | 1124443809 - POOLE ENDOSCOPY CENTER, LLC | 521831316 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
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 59020 vs. Other Surgical Procedures for Maternity Care and Delivery Codes
The CPT 59020 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 59020 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 59020. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 59020 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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