CPT 59325 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • None • AG - Primary physician • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
National average reimbursement for CPT 59325 by major payers:
$295.45
$321.10
$319.38
$388.54
| 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 59325 | ||||||
United | 59325 | $1104.00 | 1447457403 - BERGEN GASTROENTEROLOGY PC | 222713168 - (NJ) BERGEN GASTROENTEROLOGY, P.C. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59325 | $670.00 | 1609375682 - LUTHERVILLE SURGERY CENTER, LLC | 823355711 - (MD) LUTHERVILLE SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59325 | $1167.00 | 1962405803 - MID RIVERS AMBULATORY SURGERY CENTER LP, MID RIVERS SURGERY CENTER | 203833902 - (MO) MID RIVERS AMBULATORY SURGERY CENTER LP | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59325 | $561.00 | 1497206890 - MIDWEST EYE CONSULTANTS OHIO, INC., CATARACT & LASER INSTITUTE ASC - MAUMEE #352 | 300888250 - (OH) MIDWEST EYE CONSULTANTS OHIO INC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59325 | $276.00 | 1114951365 - DOCTORS SURGERY CENTER, PA | 710718664 - (AR) DOCTORS SURGERY CENTER PA | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59325 | $2281.00 | 1093444010 - SUMMIT MEDICAL GROUP PA | 223487984 - SUMMIT MEDICAL GROUP, P.A. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59325 | $6068.00 | 1386983260 - TEXAS HEALTH CRAIG RANCH SURGERY CENTER LLC | 383897811 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59325 | $1036.00 | 1992497762 - SEATTLE SURGERY CENTER LLC | 882819593 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59325 | $110.00 | 1194291401 - AFFILIATED PHYSICIANS & SURGEONS, LTD | 860495569 - (AZ) AFFILIATED PHYSICIANS SURGEONS LTD | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59325 | $934.00 | 1811978356 - WESTSIDE SURGERY CENTER, LLC | 900082030 - (OR) WESTSIDE SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59325 | $475.00 | 1083837926 - HERITAGE EYE SURGERY CENTER, LLC, PRECISION VISION SURGERY CENTER | 731097247 - (OK) EDWARD D. GLINSKI, D.O. & ACCOCIATES, INC. | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59325 | $1350.00 | 1366864514 - GREAT SOUTH BAY ENDOSCOPY CENTER, LLC | 463055867 - (NY) GREAT SOUTH BAY ENDOSCOPY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59325 | $4893.00 | 1427491547 - MEMORIAL HERMANN TEXAS INTERNATIONAL ENDOSCOPY CENTER, LLC, TEXAS INTERNATIONAL ENDOSCOPY CENTER | 462464605 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59325 | $461.00 | 1083030597 - TRIAD SURGERY CENTER, LLC, TRIAD EYE INSTITUTE | 473510624 | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59325 | $343.00 | 1659360303 - ST JOHNS SURGERY CENTER LLC | 650502027 | FL | 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 59325 vs. Other Surgical Procedures for Maternity Care and Delivery Codes
The CPT 59325 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 59325 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 |
|---|---|---|
| 59320 | Moderate | Cerclage Of Cervix,Dur.Preg;Vaginal |
| 59325 | Moderate | Cerclage Of Cervix, During Pregnancy; Ab |
| 59350 | Moderate | Hysterorrhaphy Of Ruptured Uterus |
| 59400 | High | Routine Obstetric Care Including Antepartum Care, Vaginal Delivery (With Or Without Episiotomy, And/Or Forceps) And Postpartum Care |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 59325. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 59325 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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