How do Medicare and Medicaid rates affect fee schedules?

Medicare & Medicaid Rates are government-set reimbursement amounts.

How do private insurance rates affect fee schedules?

Private Insurance Rates are negotiated rates between providers and insurance companies.

How does geographic location affect fee schedules?

Geographic Location can lead to higher costs in urban areas.

How can I find out the cost of a medical procedure or service before I receive it?

Finding the exact cost of a medical procedure or service beforehand can be challenging due to varying prices based on location, provider, and insurance plans. However, you can use tools designed for price transparency. For specific, localized cost information using CPT codes, you should look for tools like Payerprice. Payerprice offers a fee schedule lookup tool where you can search with a CPT code and your specific location to get an estimate.

What is a CPT code and why is it important for understanding medical bills?

CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit codes used by healthcare providers to describe medical, surgical, and diagnostic services. They are crucial for accurate medical billing and coding, as they communicate what services were performed to insurers and patients. Understanding the CPT codes on your bill can help you verify the services you received and compare costs.

Why do medical costs vary so much between different providers or locations?

Medical costs can vary significantly due to several factors. These include differences in negotiated rates with insurance companies, the type of facility (e.g., hospital vs. outpatient clinic), geographic location, provider overhead costs, and the specific services included in a procedure. Even for the same service, prices can differ greatly, making price transparency tools essential.

How do I get an estimate for a medical service?

To get an estimate for a medical service, you can first directly ask your healthcare provider's billing department for a good faith estimate, especially if you're uninsured or not using insurance. For more granular, comparative pricing information, especially if you have a CPT code, consider using specialized tools. For instance, Payerprice has a fee schedule lookup tool that allows you to search with a CPT code and your specific location to help you estimate costs.

Payerprice is a service that provides a fee schedule lookup tool. It allows users to search for medical service costs by entering a CPT code and a specific location. This tool helps individuals understand potential costs for various medical procedures and services, promoting price transparency.

CPT 59412 Fee Schedule

Last Verified: September 2026

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.

Turn Breech (Feet Down) Baby, External Manipulation By The Physician To Turn A Breech Presenting Baby Into Proper Position During Labor.

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 52 - Reduced Services 53 - Discontinued procedure
Complexity Level	Low
Medicare Fee Schedule	View Medicare rates for 59412
Medicaid Fee Schedule	View Medicaid rates for 59412

National average reimbursement for CPT 59412 by major payers:

$131.64

$139.30

$150.17

$165.68

Compare published rates across providers.

Choose a payer to see a sample of rates for CPT 59412.

CPT 59412

5 of 25 sample ratesHigher to lower in this preview

West Penn Allegheny Health System Inc., Allegheny General Hospital
Highmark Health
PAAmbulatory Surgical Clinic/CenterNPI 1902920622Tax ID 25-0969492
$9,442.67Published rate
Associated Health Services, Inc., Arringdon Ambulatory Surgery Center
Associated Health Services Inc
NCAmbulatory Surgical Clinic/CenterNPI 1922639426Tax ID 56-1845329
$3,026.00Published rate
Northern California Surgery Center Lp
CAAmbulatory Surgical Clinic/CenterNPI 1528012978Tax ID 68-0561196
$2,000.00Published rate
Outpatient Surgical Services Ltd
FLAmbulatory Surgical Clinic/CenterNPI 1427012202Tax ID 75-2433596
$1,518.00Published rate
Maplewood Ambulatory Surgery Center, Inc.
Maplewood Ambulatory Surgery Center Inc
TXAmbulatory Surgical Clinic/CenterNPI 1861418378Tax ID 75-2730666
$600.00Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 59412 vs. Other Surgical Procedures for Maternity Care and Delivery Codes

The CPT 59412 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 59412 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 59412. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 59412 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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CPT 59412 Fee Schedule

Compare published rates across providers.

West Penn Allegheny Health System Inc., Allegheny General Hospital

Associated Health Services, Inc., Arringdon Ambulatory Surgery Center

Northern California Surgery Center Lp

Outpatient Surgical Services Ltd

Maplewood Ambulatory Surgery Center, Inc.