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See a sample rate comparisonCPT 59409 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Vaginal Delivery Only (With Or Without Episiotomy And/Or Forceps)
| 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 |
| Common Modifiers | None AG - Primary physician U2 |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 59409 |
| Medicaid Fee Schedule | View Medicaid rates for 59409 |
National average reimbursement for CPT 59409 by major payers:
$1,037.88
$1,069.75
$1,117.54
$1,280.30
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CPT 59409
5 of 25 sample ratesHigher to lower in this preview
Antoinette Nguyen
Emory University
$2,990.57Published rateRobert Costa
$1,604.55Published rateJohn Lue
$975.00Published rateCurrent Ob/Gyn Women'S Health Center, PLLC
Current Obgyn Womens Health Center PLLC
$832.70Published rateTemple Steele
$667.14Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 59409 vs. Other Surgical Procedures for Maternity Care and Delivery Codes
The CPT 59409 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 59409 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 |
|---|---|---|
| 59400-CPT | High | Routine Obstetric Care Includi, Routine Obstetric Care Including Antepartum Care Vaginaldelivery (With Or Without Episiotomy Andor Forceps) And Postpartum Care |
| 59409-CPT | High | Vaginal Delivery Only (With Or Without Episiotomy And/Or Forceps) |
| 59410-CPT | High | Vagnal Dlvery Only (W//W/O Episiotomy &/Or Forcps); Inc, Vaginal Delivery Only (With Or Without Episiotomy And/Or Forceps); Inc |
| 59412-CPT | Low | Turn Breech (Feet Down) Baby, External Manipulation By The Physician To Turn A Breech Presenting Baby Into Proper Position During Labor. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 59409. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 59409 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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