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See a sample rate comparisonCPT 59612 Fee Schedule
Last Verified: October 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 After P, Vaginal Delivery Only After Previous Cesarean Delivery(With Or Without Episiotomy Andor 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 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 |
| Medicaid Fee Schedule | View Medicaid rates for 59612 |
National average reimbursement for CPT 59612 by major payers:
$1,161.54
$1,192.69
$1,230.18
$1,429.31
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CPT 59612
5 of 25 sample ratesHigher to lower in this preview
Memorial Ambulatory Surgery Center, LLC
Virtua-Memorial Hospital Burlington County Inc
$3,624.00Published rateAllina Health Heart And Vascular Surgery Center LLC
$2,189.00Published ratePardee Ambulatory Surgery Center LLC, The Surgery Center At Mills River
Pardee Ambulatory Surgery Center LLC
$1,599.00Published rateSunnyside Surgery Center, LLC
Sunnyside Surgery Center LLC
$1,080.00Published rateDoctors Surgery Center LLC
$614.00Published rate
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See a sample payer proposalCPT 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 P, Vaginal Delivery Only After Previous Cesarean Delivery(With Or Without Episiotomy Andor Forceps) |
| 59614-CPT | High | Vaginal Delivery Only After P, Vaginal Delivery Only After Previous Cesarean Delivery(With Or Without Episiotomy Andor Forceps) Including Postpartum Care |
| 59618-CPT | High | Routine Obstetric Care Includi, Routine Obstetric Care Including Antepartum Care Cesareandelivery And Postpartum Care Following Attempted Vaginal Delivery After Previous Cesareandelivery |
| 59620-CPT | High | Cesarean Dlvery Only Follow Attempt Vagnal Dlvery After Pre, Cesarean Delivery Only Following Attempted Vaginal Delivery After Pre |
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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