CPT 59612 Fee Schedule
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.
| 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 • GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 59612 |
National average reimbursement for CPT 59612 by major payers:
$1,161.54
$1,192.69
$1,230.18
$1,462.49
| 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 59612 | ||||||
United | 59612 | $956.00 | 1477698454 - REGIONAL EYE SURGERY CENTER,LLC | 721484653 - (LA) REGIONAL EYE SURGERY CENTER, LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $1847.00 | 1730401571 - CHILDRENS SURGERY CENTER LLC, ADVENTHEALTH SURGERY CENTER MAITLAND | 262389638 - (FL) CHILDRENS SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $1251.00 | 1366044596 - PEGASUS SURGERY CENTER LLC, PEGASUS SURGERY CENTER, LLC | 301211930 - (CA) PEGASUS SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $1286.00 | 1346308954 - DAY SURGERY OF GRAND JUNCTION LLC, DAY SURGERY OF GRAND JUNCTION | 841097113 - (CO) DAY SURGERY OF GRAND JUNCTION LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $2859.00 | 1790241073 - HSS PALM BEACH AMBULATORY SURGERY CENTER, LLC | 301015589 - (FL) HSS PALM BEACH AMBULATORY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $950.00 | 1386604908 - MATTAX NEU PRATER SURGERY CENTER, LLC | 431842771 - (MO) MATTAX NEU PRATER SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $2307.00 | 1003861998 - PHYSICIANS SURGERY CENTER OF CHATTANOOGA, LLC, PHYSICIANS SURGERY CENTER OF CHATTANOOGA | 621817952 - (TN) PHYSICIANS SURGERY CENTER OF CHATTANOOGA LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $3624.00 | 1730227992 - MEMORIAL AMBULATORY SURGERY CENTER, LLC | 210634562 - (NJ) VIRTUA-MEMORIAL HOSPITAL BURLINGTON COUNTY INC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $774.00 | 1386823854 - THE GLENDALE AZ ENDOSCOPY ASC LLC, THUNDERBIRD ENDOSCOPY CENTER | 260506545 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $950.00 | 1548844384 - GUT ENDO, LLC, CENTER FOR DIGESTIVE HEALTH | 834462225 - (AL) GUT ENDO, LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $702.00 | 1295851137 - PHYSICIANS SURGERY CENTER LLC | 200435814 - (AR) PHYSICIANS SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $2353.00 | 1306843222 - ST. JOSEPH'S OUTPATIENT SURGERY CENTER, LLC | 562332449 - (AZ) ST JOSEPHS OUTPATIENT SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $614.00 | 1184675704 - DOCTORS SURGERY CENTER LLC | 593518740 - (FL) DOCTORS SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $1080.00 | 1285825075 - SUNNYSIDE SURGERY CENTER, LLC | 201164055 - (ID) SUNNYSIDE SURGERY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $1600.00 | 1033363064 - TATTNALL HOSPITAL COMPANY, LLC, OPTIM SURGERY CENTER | 300466706 | GA | 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 59612 vs. Other Surgical Procedures for Maternity Care and Delivery Codes
The CPT 59612 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 59612 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 |
|---|---|---|
| 59612-CPT | High | Vaginal Delivery Only, After Previous Cesarean Delivery (With Or Without Episiotomy And/Or Forceps); |
| 59614-CPT | High | Vaginal Delivery Only, After Previous Cesarean Delivery (With Or Without Episiotomy And/Or Forceps); Including Postpartum Care |
| 59618-CPT | High | Routine Obstetric Care Including Antepartum Care, Cesarean Delivery, And Postpartum Care, Following Attempted Vaginal Delivery After Previous Cesarean Delivery |
| 59620-CPT | High | Cesarean Delivery Only, Following Attempted Vaginal Delivery After Previous Cesarean Delivery; |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 59612. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 59612 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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