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 |
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 | $1551.73 | 1467415117 - MARLON JORDAN | 350593390 - DEACONESS HOSPITAL INC | IL | Cardiovascular Disease Physician (207RC0000X) |
United | 59612 | $2959.00 | 1023070026 - TOMS RIVER SURGERY CENTER, LLC, TOMS RIVER SURGERY CENTER | 752854783 - (NJ) TOMS RIVER SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $988.00 | 1093993727 - CAROLINA MOUNTAIN GASTROENTEROLOGY ENDOSCOPY CENTER | 261708694 - (NC) CAROLINA MOUNTAIN GASTROENTEROLOGY ENDOSCOPY CENTER | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $1471.00 | 1386677326 - INLAND EYE SPECIALISTS A MEDICAL CORP, INLAND EYE SPECIALISTS | 330585144 - (CA) INLAND EYE SPECIALISTS, A MEDICAL CORPORATION | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
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 | $2189.00 | 1679235584 - ALLINA HEALTH HEART AND VASCULAR SURGERY CENTER LLC | 872158427 - (MN) ALLINA HEALTH HEART AND VASCULAR SURGERY CENTER LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $2859.00 | 1225375587 - GCSA AMBULATORY SURGERY CENTER, LLC, GASTROENTEROLOGY CONSULTANTS OF SAN ANTONIO - STONE OAK | 611699459 - (TX) GCSA AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $1834.00 | 1356124309 - SAINT LUKE'S NORTH SURGERY CENTER, LLC | 920591506 - (MO) SAINT LUKES NORTH SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $890.00 | 1386681161 - SUNCOAST SPECIALTY SURGERY CENTER, LLLP | 204570672 - (FL) SUNCOAST SPECIALTY SURGERY CENTER LLLP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $445.00 | 1235165531 - LAKE SURGERY & ENDOSCOPY CENTER LTD | 593325730 - (FL) LAKE SURGERY ENDOSCOPY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $2388.00 | 1912378357 - DAVENPORT AMBULATORY SURGERY CENTER, L.L.C. | 881811228 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $513.00 | 1083654636 - PLASTIC SURGERY SPECIALISTS, PC, NORTH ARUNDEL PLASTIC SURGERY SPECIALISTS | 521357688 - (MD) PLASTIC SURGERY SPECIALISTS, P.C. | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $1850.00 | 1689173981 - MAO LEAWOOD SURGERY CENTER LLC | 812903525 - (KS) MAO LEAWOOD SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $1045.00 | 1659594307 - EYE SURGERY CENTER OF NORTHERN NEVADA, LLC | 205368967 - (NV) EYE SURGERY CENTER OF NORTHERN NEVADA LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59612 | $1847.00 | 1558580910 - ORANGE CITY SURGICAL LLC, ADVENTHEALTH SURGERY CENTER BLUE SPRINGS | 208105013 - (FL) ORANGE CITY SURGICAL, LLC | FL | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 59612) and we'll show you how you compare in 15 minutes or less.