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 |
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 | $219.00 | 1619576824 - SURGICARE OF LA VETA, LTD., NEWPORT COAST SURGICAL INSTITUTE | 752507129 | 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 | $142.00 | 1801343496 - TRADITION SURGERY CENTER, LLC | 364837780 - (FL) TRADITION SURGERY CENTER LLC | FL | 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 | $88.00 | 1467442657 - HOLY REDEEMER AMBULATORY SURGERY CENTER, LLC | 233020527 - (PA) HOLY REDEEMER AMBULATORY SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59076 | $508.00 | 1386619682 - HUTCHINSON CLINIC, P.A., INC., HUTCHINSON CLINIC ENDOSCOPY CENTER | 480734011 - (KS) HUTCHINSON CLINIC, P.A. | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59076 | $500.00 | 1356672919 - CPMSC ROSWELL, LLC | 271697405 - (GA) CPMSC ROSWELL LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59076 | $100.00 | 1154318103 - OPTUM CARE WASHINGTON PLLC, OPTUM - KEMP SURGERY CENTER | 910214500 - THE EVERETT CLINIC, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59076 | $531.00 | 1366935074 - SKYWAY SURGERY CENTER, LLC | 813237016 - (FL) SKYWAY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59076 | $506.00 | 1790344182 - BRISTOL AMBULATORY SURGERY CENTER, LLC | 834345983 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59076 | $344.00 | 1528000817 - SOUTHWESTERN EYE CENTER LTD, SOUTHWESTERN EYE CENTER | 860423068 - SOUTHWESTERN EYE CENTER, LTD. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59076 | $102.00 | 1245340603 - MOUNTAIN EMPIRE CATARACT & EYE SURGERY CENTER | 30408358 - (TN) MOUNTAIN EMPIRE CATARACT EYE SURGERY CENTER | TN | 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 | $1831.00 | 1518344043 - MEMORIAL HERMANN SURGERY CENTER KIRBY, LLC, MEMORIAL HERMANN SURGERY CENTER KIRBY GLEN | 364801162 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59076 | $134.00 | 1467101907 - PEACE RIVER SURGERY CENTER | 853047089 | FL | 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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