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 |
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 | $214.17 | 1598085854 - GERILYNN VINE | 204923281 - MEMORIAL HERMANN MEDICAL GROUP | TX | Obstetrics & Gynecology Physician (207V00000X) |
United | 59320 | $208.02 | 1992837975 - BARBARA TAYLOR-COX | 204923281 - MEMORIAL HERMANN MEDICAL GROUP | TX | Pediatrics Physician (208000000X) |
United | 59320 | $726.86 | 1326375569 - POLLI RAYBURN | 752740653 - (TX) MAGELLA MEDICAL ASSOCIATES BILLING INC | TX | Neonatal Nurse Practitioner (363LN0000X) |
United | 59320 | $220.82 | 1336173285 - SUSAN CHON | 760459500 - U T PHYSICIANS | TX | Dermatology Physician (207N00000X) |
United | 59320 | $220.69 | 1831120047 - MOHAMMAD ZARE-MEHRJERDI | 760459500 - U T PHYSICIANS | TX | Family Medicine Physician (207Q00000X) |
United | 59320 | $136.14 | 1447891270 - DEVON KNOWLES | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Physician Assistant (363A00000X) |
United | 59320 | $214.17 | 1740322759 - REMILEKUN DOSUMU | 204923281 - MEMORIAL HERMANN MEDICAL GROUP | TX | Internal Medicine Physician (207R00000X) |
United | 59320 | $152.28 | 1730539438 - MEAGAN CHOATES | 760459500 - U T PHYSICIANS | TX | Genetic Counselor (M.S.) (170300000X) |
United | 59320 | $187.53 | 1689202475 - THEODORE INTHAPHOM | 760459500 - U T PHYSICIANS | TX | Medical Physician Assistant (363AM0700X) |
United | 59320 | $726.86 | 1043211394 - CRAIG STEINER | 752740653 - (TX) MAGELLA MEDICAL ASSOCIATES BILLING INC | TX | Neonatal-Perinatal Medicine Physician (2080N0001X) |
United | 59320 | $306.33 | 1023593456 - LAURA CERVANTES | 752740653 - (TX) MAGELLA MEDICAL ASSOCIATES BILLING INC | TX | Pediatric Nurse Practitioner (363LP0200X) |
United | 59320 | $145.41 | 1154953214 - SHANNA ROARK | 204923281 - MEMORIAL HERMANN MEDICAL GROUP | TX | Critical Care Medicine Nurse Practitioner (363LC0200X) |
United | 59320 | $202.00 | 1649465584 - STEVEN WALKER | 204923281 - MEMORIAL HERMANN MEDICAL GROUP | TX | Internal Medicine Physician (207R00000X) |
United | 59320 | $245.07 | 1093134595 - KEVIN GLINTON | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Clinical Genetics (M.D.) Physician (207SG0201X) |
United | 59320 | $214.17 | 1740586411 - TOPE AJIBADE | 204923281 - MEMORIAL HERMANN MEDICAL GROUP | OH | Hospitalist Physician (208M00000X) |
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 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.
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