CPT 59320 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 • GC - Service performed by resident under supervision • AG - Primary physician |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 59320 |
National average reimbursement for CPT 59320 by major payers:
$200.42
$204.76
$215.37
$249.00
| 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 59320 | ||||||
United | 59320 | $208.02 | 1316907017 - ANNE PEARSON | 204923281 - MEMORIAL HERMANN MEDICAL GROUP | TX | Family Medicine Physician (207Q00000X) |
United | 59320 | $726.86 | 1326375569 - POLLI RAYBURN | 752740653 - (TX) MAGELLA MEDICAL ASSOCIATES BILLING INC | TX | Neonatal Nurse Practitioner (363LN0000X) |
United | 59320 | $245.07 | 1265427835 - HOWARD WEINER | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Neurological Surgery Physician (207T00000X) |
United | 59320 | $1656.00 | 1568445062 - EYE SURGERY & LASER CENTER OF WISCONSIN LLC | 461222222 | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59320 | $3500.00 | 1295702942 - GRAPEVINE SURGICARE PARTNERS LTD, BAYLOR SCOTT & WHITE SURGICARE - SOUTHLAKE | 752854711 - (TX) GRAPEVINE SURGICARE PARTNERS LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59320 | $920.00 | 1750612446 - BAY SURGERY CENTERS, CLEARWAY SURGERY CENTER OF GLEN BURNIE | 271271303 - (MD) BAY SURGERY CENTERS | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59320 | $208.02 | 1992837975 - BARBARA TAYLOR-COX | 204923281 - MEMORIAL HERMANN MEDICAL GROUP | TX | Pediatrics Physician (208000000X) |
United | 59320 | $220.82 | 1336173285 - SUSAN CHON | 760459500 - U T PHYSICIANS | TX | Dermatology Physician (207N00000X) |
United | 59320 | $894.00 | 1255070116 - MERCY SOUTH ASC LLC, MERCY OUTPATIENT SURGERY CENTER - WEST BEND | 882512783 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59320 | $220.82 | 1144648288 - MEERA SUBASH | 760459500 - U T PHYSICIANS | TX | Rheumatology Physician (207RR0500X) |
United | 59320 | $272.29 | 1013414895 - STEPHANIE BAEK | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Anesthesiology Physician (207L00000X) |
United | 59320 | $1200.00 | 1023570488 - SIGHT PARTNERS, LLC, NORTHWEST EYE SURGEONS | 833467355 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59320 | $1307.00 | 1346287232 - MODESTO SURGERY CENTER | 770394007 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59320 | $2353.00 | 1740328947 - ENDOSCOPY CONSULTANTS, LLC | 510425612 - (GA) ENDOSCOPY CONSULTANTS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59320 | $220.82 | 1245692649 - DIVYA BHAMIDIPATI | 760459500 - U T PHYSICIANS | TX | Infectious Disease Physician (207RI0200X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 59320 vs. Other Surgical Procedures for Maternity Care and Delivery Codes
The CPT 59320 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 59320 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 59320. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 59320 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 59320) and we'll show you how you compare in 15 minutes or less.