CPT 59076 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 • 80 - Assistant surgeon • GC - Service performed by resident under supervision • 76 - Repeat procedure by same physician |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 59076 |
National average reimbursement for CPT 59076 by major payers:
$605.15
$672.35
$660.54
$822.87
| 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 59076 | ||||||
United | 59076 | $112.00 | 1720058688 - SURGICENTER OF NORFOLK, LLC, FOUNTAIN POINT SURGERY CENTER | 582458164 - (NE) SURGICENTER OF NORFOLK LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59076 | $200.00 | 1528061918 - CATARACT SPECIALTY SURGICAL CENTER, LLC, CATARACT SPECIALTY SURGICAL CENTER | 200225369 - (MI) CATARACT SPECIALTY SURGICAL CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59076 | $116.00 | 1528643285 - SUMMIT HEALTH PARTNERS LLC, WESTERN CAROLINA SURGERY CENTER | 812722973 - (NC) SUMMIT HEALTH PARTNERS LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59076 | $163.00 | 1679791404 - SILVER SUMMIT MEDICAL CORPORATION, PREMIER SURGERY CENTER | 770284440 - (CA) SILVER SUMMIT MEDICAL CORPORATION | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59076 | $230.00 | 1366873515 - BANNER ESTRELLA SURGERY CENTER | 901183954 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59076 | $95.00 | 1770572307 - BETHESDA SURGERY CENTER, LLC | 522080005 - (MD) BETHESDA SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59076 | $477.00 | 1457725392 - THE ENDOSCOPY CENTER OF QUEENS INC | 262427823 - (NY) THE ENDOSCOPY CENTER OF QUEENS INC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59076 | $150.00 | 1184660151 - INNOVATIVE PROCEDURAL CENTER LLC | 200327828 - (SD) INNOVATIVE PROCEDURE CENTER LLC | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59076 | $327.00 | 1033190566 - NORTHERN INDIANA AMBULATORY SURGERY CENTER, RIVERPOINTE SURGERY CENTER | 351994079 - NORTHERN INDIANA AMBULATORY SURGERY CENTER, LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59076 | $207.00 | 1578593224 - K S MANAGEMENT SERVICES LLC, KELSEY-SEYBOLD ASC | 842241460 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59076 | $260.00 | 1164534400 - MISSION HILLS SURGICENTER, LLC, MISSION HILLS PAIN TREATMENT CENTER | 203206715 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59076 | $203.00 | 1972055382 - ALLIANCE SURGERY PARTNERS, LLC | 901108673 - (CA) ALLIANCE SURGERY PARTNERS LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59076 | $688.00 | 1750565594 - PEDIATRIC SURGERY CENTER -ODESSA, LLC | 651274446 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59076 | $95.00 | 1780140772 - ADIOS ESTENOSIS LLC, AZURA SURGERY CENTER LAS VEGAS | 384077592 - (NV) ADIOS ESTENOSIS LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59076 | $118.00 | 1699817346 - CASCADE EYE & SKIN CENTERS PC, CASCADE LASER & SURGERY CENTER | 911525215 - (WA) CASCADE EYE AND SKIN CENTERS, P.C. | WA | 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 59076 vs. Other Surgical Procedures for Maternity Care and Delivery Codes
The CPT 59076 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 59076 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 |
|---|---|---|
| 59070-CPT | Moderate | Transabdominal Amnioinfusion, Including Ultrasound Guidance |
| 59072-CPT | Moderate | Fetal Umbilical Cord Occlusion, Including Ultrasound Guidance |
| 59074-CPT | Moderate | Fetal Fluid Drainage (Eg, Vesicocentesis, Thoracocentesis, Paracentesis), Including Ultrasound Guidance |
| 59076-CPT | Moderate | Fetal Shunt Placement, 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 59076. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 59076 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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