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See a sample rate comparisonCPT 59430 Fee Schedule
Last Verified: October 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.
Care Of Mother After Delivery, Routine Care Of The Mother After Childbirth (Postpartum Care).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures for Maternity Care and Delivery |
| Common Place of Service | 11 - Office 50 - Federally Qualified Health Center |
| Common Modifiers | None TH SA |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 59430 |
| Medicaid Fee Schedule | View Medicaid rates for 59430 |
National average reimbursement for CPT 59430 by major payers:
$254.71
$248.72
$296.63
$356.33
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CPT 59430
5 of 25 sample ratesHigher to lower in this preview
Rimsha Ahmed
$943.21Published rateSavannah Micolucci
Prisma Health-University Medical Group
$461.10Published rateKatia Castillo
Atlanta Womens Health Group, P.C.
$400.89Published rateMitchell Brock
Cooperative Healthcare Services Inc
$196.25Published rateAshley Eskew
Reproductive Specialists Of The
$134.66Published rate
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See a sample payer proposalCPT 59430 vs. Other Surgical Procedures for Maternity Care and Delivery Codes
The CPT 59430 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 59430 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 |
|---|---|---|
| 59426-CPT | High | Antepartum Care Only; 7 Or More Visits |
| 59430-CPT | Moderate | Care Of Mother After Delivery, Routine Care Of The Mother After Childbirth (Postpartum Care). |
| 59510-CPT | High | Routine Obstetric Care Includi, Routine Obstetric Care Including Antepartum Care Cesareandelivery And Postpartum Care Routine Obstetric Care Including Antepartum Care Cesarean |
| 59514-CPT | High | C-Section Childbirth, Delivery Of A Newborn By Cesarean (C-Section). A C-Section Is A Surgery That Removes The Newborn From The Uterus By Cutting Into The Abdomen. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 59430. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 59430 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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