CPT 59620 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 • 11 - Office • None |
| Common Modifiers | • None • 80 - Assistant surgeon • AG - Primary physician |
| Complexity Level | High |
National average reimbursement for CPT 59620 by major payers:
$1,258.58
$1,269.40
$1,281.60
$1,537.74
| 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 59620 | ||||||
United | 59620 | $450.00 | 1831349406 - GASTROENTEROLOGY EAST, P.A. | 202964888 - (NC) GASTROENTEROLOGY EAST, P.A. | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59620 | $624.00 | 1912174996 - PACIFIC CATARACT AND LASER INSTITUTE INC PC | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | MT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59620 | $494.50 | 1679612253 - WALKER SURGICAL CENTER LLC | 810635117 - (MI) WALKER SURGICAL CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59620 | $238.00 | 1023115078 - MAIN LINE PA ENDOSCOPY ASC LP, MAIN LINE ENDOSCOPY CENTER MALVERN | 205301211 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59620 | $2208.00 | 1306249453 - MARK FROMER, LLC, EYE SURGERY CENTERS OF NEW YORK | 274212773 - (NY) MARK FROMER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59620 | $1127.00 | 1427471911 - NORTHWOODS SURGERY CENTER LLC | 462454295 - (MN) NORTHWOODS SURGERY CENTER, LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59620 | $1350.00 | 1366864514 - GREAT SOUTH BAY ENDOSCOPY CENTER, LLC | 463055867 - (NY) GREAT SOUTH BAY ENDOSCOPY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59620 | $206.00 | 1407801509 - ATLANTIC SURGERY CENTER,LLC | 223625894 - (NJ) ATLANTIC SURGERY CENTERLLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59620 | $640.00 | 1386721249 - ALLIED PHYSICIANS SURGERY CENTER, LLC | 352057452 - (IN) ALLIED PHYSICIANS SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59620 | $805.00 | 1750362869 - EYE HEALTH EASTSIDE SURGERY CENTER | 680568557 - (OR) EYE HEALTH EASTSIDE SURGERY CENTER | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59620 | $737.96 | 1790205862 - SHEA SOUDERS | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 59620 | $3013.00 | 1871575043 - AMBULATORY SURGERY CENTER OF COOL SPRINGS LLC, VANDERBILT SURGERY CENTER COOL SPRINGS | 621809227 - (TN) AMBULATORY SURGERY CENTER OF COOL SPRINGS LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59620 | $4825.00 | 1184752305 - SEASHORE SURGICAL INSTITUTE, LLC | 223660141 - (NJ) SEASHORE SURGICAL INSTITUTE | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59620 | $274.00 | 1447748470 - CTS SURGICAL ASSOCIATES LLC, CEDAR TREE SURGICAL CENTER | 825298503 | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59620 | $1274.00 | 1043803877 - PALM BEACH INTERNATIONAL SURGERY CENTER LLC, PALM BEACH INTERNATIONAL SURGERY CENTER AT THE PALEY INSTITUTE | 384092545 - (FL) PALM BEACH INTERNATIONAL SURGERY CENTER 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 |
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CPT 59620 vs. Other Surgical Procedures for Maternity Care and Delivery Codes
The CPT 59620 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 59620 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 59620. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 59620 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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