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See a sample rate comparisonCPT 59130 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Surg.Tx-Ectopic Pregnancy;Abd Preg.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures for Maternity Care and Delivery |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | None 80 - Assistant surgeon AG - Primary physician GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 59130 |
| Medicaid Fee Schedule | View Medicaid rates for 59130 |
National average reimbursement for CPT 59130 by major payers:
$1,141.54
$1,214.28
$1,197.93
$1,466.86
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CPT 59130
5 of 25 sample ratesHigher to lower in this preview
Seashore Surgical Institute, LLC
Seashore Surgical Institute
$4,300.00Published rateSummit Ambulatory Surgical Center, LLC
$1,028.00Published rateNiagara Health Center, Inc
Niagara Health Center
$750.00Published rateEndoscopy Associates, LLC
Endoscopy Associates LLC
$425.00Published rateSarasota Ophthalmology Asc LLC, Center For Advanced Eye Surgery
Sarasota Ophthalmology Asc LLC
$250.00Published rate
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See a sample payer proposalCPT 59130 vs. Other Surgical Procedures for Maternity Care and Delivery Codes
The CPT 59130 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 59130 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 |
|---|---|---|
| 59100-CPT | High | Removal Of Uterine Contents, This Surgery Removes The Uterine Contents When A Pregnancy Fails And Forms A Cluster Of Cells Called A Hydatidiform Mole. |
| 59120-CPT | Moderate | Surgery For Ectopic Pregnancy, Surgery For A Pregnancy Developing Outside The Uterus (Ectopic). The Procedure May Include Removal Of An Ovary Or Fallopian Tube. |
| 59121-CPT | Moderate | Surgery For Ectopic Pregnancy, Surgery For A Pregnancy Developing Outside The Uterus (Ectopic). The Procedure May Include Removal Of An Ovary Or Fallopian Tube. |
| 59130-CPT | High | Surg.Tx-Ectopic Pregnancy;Abd Preg. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 59130. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 59130 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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