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See a sample rate comparisonCPT 59200 Fee Schedule
Last Verified: October 2026
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.
Dilate Cervix For Labor, The Procedure Starts Labor Contractions By Dilating (Opening) The Cervix. A Suppository Is Placed Into The Cervical Canal To Cause The Cervix Opening To Enlarge.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures for Maternity Care and Delivery |
| Common Place of Service | 21 - Inpatient Hospital 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service UD |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 59200 |
| Medicaid Fee Schedule | View Medicaid rates for 59200 |
National average reimbursement for CPT 59200 by major payers:
$108.09
$109.49
$125.93
$81.94
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CPT 59200
5 of 25 sample ratesHigher to lower in this preview
Hagerstown Surgery Center,LLC
Hagerstown Surgery Center, LLC
$506.00Published rateSucharitha Vigneshwar
$169.38Published rateDavid Schultz
Deaconess Hospital Inc
$133.69Published rateLeah Hong
Allegiance Health
$95.19Published rateRestorative Health Rehabilitation Inc
$55.00Published rate
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See a sample payer proposalCPT 59200 vs. Other Surgical Procedures for Maternity Care and Delivery Codes
The CPT 59200 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 59200 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 |
|---|---|---|
| 59150-CPT | High | Surgery For Ectopic Pregnancy, Surgery For A Pregnancy Developing Outside The Uterus (Ectopic). The Procedure May Include Removal Of An Ovary Or Fallopian Tube. |
| 59151-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. |
| 59160-CPT | Moderate | Removal Of Uterine Contents, This Procedure Removes Tissues Remaining In The Uterus Instead Of Being Expelled During Childbirth. |
| 59200-CPT | Low | Dilate Cervix For Labor, The Procedure Starts Labor Contractions By Dilating (Opening) The Cervix. A Suppository Is Placed Into The Cervical Canal To Cause The Cervix Opening To Enlarge. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 59200. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 59200 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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