CPT 59074 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 • 51 - Multiple procedures • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 59074 |
National average reimbursement for CPT 59074 by major payers:
$450.54
$511.00
$499.58
$623.44
| 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 59074 | ||||||
United | 59074 | $163.00 | 1841298437 - WEST PALM OUTPATIENT SURGERY AND LASER CENTER LTD, NORTHPOINT SURGERY & LASER CENTER | 650592518 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59074 | $85.00 | 1497296198 - MIDATLANTIC ENDOSCOPY LLC, MID-ATLANTIC GASTROINTESTINAL CENTER II | 814079161 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59074 | $923.00 | 1659793891 - INOVA AMBULATORY SURGERY CENTER AT LORTON, LLC | 461955980 - (VA) INOVA AMBULATORY SURGERY CENTER AT LORTON LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59074 | $150.00 | 1790174274 - PARKSIDE SURGERY CENTER, LLC | 472815348 - (TX) PARKSIDE SURGERY CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59074 | $178.00 | 1750927190 - HERMITAGE ENDOSCOPY CENTER INC | 841815468 - (PA) HERMITAGE ENDOSCOPY CENTER INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59074 | $1301.00 | 1316359532 - LONE STAR ENDOSCOPY CENTER, LLC | 273635726 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59074 | $136.00 | 1285678979 - BAY SURGERY CENTERS LLC, CLEARWAY SURGERY CENTER OF ANNAPOLIS | 204934078 - (MD) BAY SURGERY CENTERS LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59074 | $1957.00 | 1083776314 - CROZER-CHESTER MEDICAL CENTER | 811507712 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59074 | $47.00 | 1710591060 - MIDSOUTH INTERVENTIONAL PAIN INSTITUTE, LLC | 272910652 - MIDSOUTH INTERVENTIONAL PAIN INSTITUTE LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59074 | $109.00 | 1053058255 - INDIANA VASCULAR SURGERY CENTER LLC | 871608290 - (IN) INDIANA VASCULAR SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59074 | $92.00 | 1760770903 - ASSOCIATED SURGICAL CENTER OF DEARBORN LLC | 275209399 - (MI) ASSOCIATED SURGICAL CENTER OF DEARBORN LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59074 | $128.00 | 1285381004 - THE NEBRASKA AMBULATORY SURGICAL CENTER, LLC, THE NEBRASKA AMBULATORY SURGICAL CENTER | 872477902 - (NE) THE NEBRASKA AMBULATORY SURGICAL CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59074 | $85.00 | 1255872784 - MIDATLANTIC ENDOSCOPY LLC, MID-ATLANTIC GASTROINTESTINAL CENTER | 814079161 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59074 | $168.00 | 1881704237 - WATERFRONT SURGERY CENTER LLC | 251898743 - (PA) WATERFRONT SURGERY CENTER | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59074 | $225.00 | 1952852345 - HUEBNER AMBULATORY SURGERY CENTER, LLC | 813360799 - (TX) HUEBNER AMBULATORY SURGERY CENTER LLC | TX | 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 59074 vs. Other Surgical Procedures for Maternity Care and Delivery Codes
The CPT 59074 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 59074 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 |
| 59074-CPT | Moderate | Fetal Fluid Drainage (Eg, Vesicocentesis, Thoracocentesis, Paracentesis), 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 59074. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 59074 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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