CPT 59072 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • AG - Primary physician • UB |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 59072 |
National average reimbursement for CPT 59072 by major payers:
$610.32
$673.76
$661.28
$824.11
| 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 59072 | ||||||
United | 59072 | $121.00 | 1477917151 - WHITE OAK SURGERY CENTER | 273885555 - (GA) WHITE OAK SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59072 | $50.00 | 1215028469 - DEL VAL ASC LLC, THE EYE SURGERY CENTER | 760788813 - (PA) DEL VAL ASC LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59072 | $150.00 | 1881193183 - SOUTHSIDE SPECIALTY SURGICAL CENTER LLC | 823920550 - (TX) SOUTHSIDE SPECIALTY SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59072 | $555.00 | 1689664906 - PEDIATRIC SURGERY CENTERS, LLC | 201711553 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59072 | $962.54 | 1699252395 - LINDUSTRIES, LLC, SEVENTH AVENUE SURGERY CENTER | 825145499 - (NE) LINDUSTRIES LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59072 | $301.00 | 1548984263 - ALLINA HEALTH SURGERY CENTER | 883732480 | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59072 | $1511.00 | 1174969372 - AURORA GI ASC LLC, WISCONSIN DIGESTIVE HEALTH CENTER | 461848055 - (WI) AURORA GI ASC LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59072 | $907.00 | 1134183908 - NORTH PALM BEACH COUNTY SURGERY CENTER LLC | 752424900 - (FL) NORTH PALM BEACH COUNTY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59072 | $202.00 | 1134140122 - ARTHROSCOPIC SURGERY CENTER, LLC | 392000854 - (WI) ARTHROSCOPIC SURGERY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59072 | $42.00 | 1336184027 - EYE SURGICENTER LLC | 651005108 - (FL) EYE SURGICENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59072 | $589.00 | 1831484567 - GRIFFISS EC, LLC, GRIFFISS EYE SURGERY CENTER | 263738675 - (NY) GRIFFISS EC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59072 | $566.00 | 1831180272 - ADVANCED ENDOSCOPY CENTER LLC | 861083384 - (MO) ADVANCED ENDOSCOPY CENTER, LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59072 | $135.00 | 1275522849 - COLIMA ENDOSCOPY CENTER INC, COLIMA ENDOSCOPY CENTER | 954611492 - (CA) COLIMA ENDOSCOPY CENTER, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59072 | $633.00 | 1275545279 - SURGERY CENTER OF COLUMBIA LP | 205227138 - (MO) SURGERY CENTER OF COLUMBIA LP | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59072 | $979.00 | 1659335438 - RESTON SURGERY CENTER, LP | 113654617 - (VA) RESTON SURGERY CENTER LP | VA | 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 59072 vs. Other Surgical Procedures for Maternity Care and Delivery Codes
The CPT 59072 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 59072 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.
| Code | Complexity | Description |
|---|---|---|
| 59030-CPT | Low | Fetal Scalp Blood Sampling |
| 59050-CPT | Low | Fetal Monitoring During Labor By Consulting Physician (Ie, Non-Attending Physician) With Written Report; Supervision And Interpretation |
| 59051-CPT | Low | Fetal Monitoring During Labor By Consulting Physician (Ie, Non-Attending Physician) With Written Report; Interpretation Only |
| 59072-CPT | Moderate | Fetal Umbilical Cord Occlusion, Including Ultrasound Guidance |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 59072. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 59072 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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