CPT 59136 Fee Schedule
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.
| 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 |
| Common Modifiers | • None • 80 - Assistant surgeon • AG - Primary physician |
| Complexity Level | High |
National average reimbursement for CPT 59136 by major payers:
$1,115.72
$1,177.59
$1,167.36
$1,446.78
| 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 59136 | ||||||
United | 59136 | $662.00 | 1588620306 - SPECIALTY ORTHOPAEDICS SURGERY CENTER | 201170147 - (GA) SPECIALTY ORTHOPAEDICS SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59136 | $2517.00 | 1578566758 - ADVANCED AMBULATORY SURGICAL CARE, LP, ADVANCED SURGICAL CARE | 203833272 - (MO) ADVANCED AMBULATORY SURGICAL CARE LP | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59136 | $1000.00 | 1528219474 - CLARKSTON ASC PARTNERS LLC, CLARKSTON SURGERY CENTER | 203360827 - (MI) CLARKSTON ASC PARTNERS, LLC DBA CLARKSTON SURGERY CENTER | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59136 | $335.00 | 1508813627 - FOUR STATES SURGERY CENTER, PC, FOUR STATES SURGERY CENTER, | 201498725 - (MO) FOUR STATES SURGERY CENTER, PC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59136 | $1344.00 | 1477584621 - HANOVER NJ ENDOSCOPY ASC LLC, HANOVER ENDOSCOPY CENTER | 201272329 - (NJ) HANOVER NJ ENDOSCOPY ASC LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59136 | $807.00 | 1063878734 - CESC, LLC | 811020132 | ME | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59136 | $775.00 | 1841955358 - ADVENTIST HEALTHCARE SC AT NATIONAL HARBOR, LLC | 852814304 - (MD) ADVENTIST HEALTHCARE SC AT NATIONAL HARBOR LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59136 | $464.00 | 1346596566 - SCP INDIANAPOLIS LLC | 460639908 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59136 | $1049.00 | 1366406233 - MIDDLE TENNESSEE AMBULATORY SURGERY CENTER, L.P. | 621699667 - (TN) MIDDLE TENNESSEE AMBULATORY SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59136 | $632.00 | 1275178444 - KENOSHA DIGESTIVE HEALTH CENTER LLC | 842167873 - (WI) KENOSHA DIGESTIVE HEALTH CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59136 | $450.00 | 1447600416 - POTTSTOWN AMBULATORY CENTER, LLC | 474556636 - (PA) POTTSTOWN AMBULATORY CENTER LL | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59136 | $758.00 | 1821421256 - MONOCACY SURGERY CENTER LLC | 462861862 - (MD) MONOCACY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59136 | $1441.00 | 1396213294 - UH NORTH RIDGEVILLE ENDOSCOPY CENTER LLC | 831320776 - (OH) UH NORTH RIDGEVILLE ENDOSCOPY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59136 | $670.00 | 1184106049 - SURGCENTER OF NORTHERN BALTIMORE, LLC | 823078615 - (MD) SURGCENTER OF NORTHERN BALTIMORE LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59136 | $734.00 | 1912641788 - PACIFIC NORTHWEST SURGERY CENTER LLC | 842331435 - (OR) PACIFIC NORTHWEST SURGERY CENTER LLC | OR | 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 59136 vs. Other Surgical Procedures for Maternity Care and Delivery Codes
The CPT 59136 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 59136 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 | Hysterotmy,Abd Eg,For Hydatidiform Mole |
| 59120-CPT | Moderate | Surgical Treatment Of Ectopic Pregnancy; Tubal Or Ovarian, Requiring Salpingectomy And/Or Oophorectomy, Abdominal Or Vaginal Approach |
| 59121-CPT | Moderate | Treatment Tubal Pregnancy |
| 59136-CPT | High | Surg.Tx-Ectop.Preg;Intst,Part Resec |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 59136. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 59136 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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