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 |
| Medicare Fee Schedule | View Medicare rates for 59325 |
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 | $7400.00 | 1336180173 - BELTWAY SURGERY CENTERS LLC | 352072586 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59325 | $578.00 | 1972831998 - SAN DIEGO SKIN, INC. | 203245033 - (CA) SAN DIEGO SKIN, INC M MARK MOFID MD APC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59325 | $504.00 | 1538122072 - GREATER NEW BEDFORD SURGICENTER | 460608742 | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59325 | $982.00 | 1154387710 - WARNER PARK SURGERY CENTER LLC, CENTER FOR ADVANCED SURGERY | 752824260 - (AZ) WARNER PARK SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59325 | $867.00 | 1770042111 - O'FALLON SURGICAL CENTER, LLC, PHYSICIANS SURGICAL CENTER | 841973218 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59325 | $600.00 | 1194970418 - PACIFIC CATARACT AND LASER INSTITUTE INC PC | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59325 | $713.00 | 1174030878 - STUART SURGERY CENTER, LLC | 822542219 - (FL) STUART SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59325 | $309.00 | 1366032617 - EMERSON ENDOSCOPY AND DIGESTIVE HEALTH CENTER, LLC | 843673604 - (MA) EMERSON ENDOSCOPY AND DIGESTIVE HEALTH CENTER LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59325 | $1049.00 | 1003058744 - YORK COUNTY ENDOSCOPY CENTER LLC | 463366385 | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59325 | $1010.00 | 1174197990 - KANSAS CITY SURGERY CENTER, LLC | 853624014 - (KS) KANSAS CITY SURGERY CENTER LLC | KS | 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 | $400.00 | 1801855127 - CENTER FOR THE SURGICAL ARTS LLC, CSA | 113741353 - (PA) CENTER FOR THE SURGICAL ARTS LLC | PA | 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 | $492.00 | 1275569121 - SOUTHWESTERN EYE CENTER LTD, SOUTHWESTERN EYE SURGICENTER-CASA GRANDE | 860423068 - SOUTHWESTERN EYE CENTER, LTD. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59325 | $400.00 | 1164734232 - MIDSOUTH INTERVENTIONAL PAIN INSTITUTE, LLC | 261545635 - MIDSOUTH INTERVENTIONAL PAIN INSTITUTE LLC | TN | 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-CPT | Moderate | Cerclage Of Cervix,Dur.Preg;Vaginal |
| 59325-CPT | Moderate | Cerclage Of Cervix, During Pregnancy; Ab |
| 59350-CPT | Moderate | Hysterorrhaphy Of Ruptured Uterus |
| 59400-CPT | 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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