CPT 59850 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures for Maternity Care and Delivery |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • AG - Primary physician • 51 - Multiple procedures |
| Complexity Level | Moderate |
National average reimbursement for CPT 59850 by major payers:
$468.33
$500.47
$492.25
$622.35
| 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 59850 | ||||||
United | 59850 | $307.00 | 1528099207 - DEER CREEK SURGERY CENTER, LLC | 202255269 - (KS) DEER CREEK SURGERY CENTER, LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59850 | $829.00 | 1629517800 - NORTHWEST SURGERY CENTER, LLC | 352210163 - LEWIS & CLARK ORTHOPAEDIC, LLC 401(K) PLAN | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59850 | $1049.00 | 1275870537 - GCSA AMBULATORY SURGERY CENTER, LLC | 611699459 - (TX) GCSA AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59850 | $2375.00 | 1528335148 - SHRINERS HOSPITALS FOR CHILDREN, SHRINERS HOSPITALS FOR CHILDREN - ERIE AMBULATORY SURGERY CENTER | 362193608 - SHRINERS HOSPITALS FOR CHILDREN | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59850 | $795.00 | 1407836315 - SPINE CARE DELAWARE, LLC | 510393046 - (DE) SPINE CARE DELAWARE LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59850 | $1049.00 | 1184687386 - DIGESTIVECARE, LLC, DIGESTIVECARE ENDOSCOPY UNIT | 311108485 - (OH) DIGESTIVE CARE, INC. | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59850 | $100.00 | 1063408649 - AIMS OUTPATIENT SURGERY | 860751146 - (AZ) AIMS OUTPATIENT SURGERY | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59850 | $380.00 | 1396852570 - EAGLE PHYSICIANS AND ASSOCIATES PA, EAGLE ENDOSCOPY CENTER | 561847193 - EAGLE PHYSICIANS & ASSOCIATES, P.A. | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59850 | $6068.00 | 1023316197 - NORTH DALLAS SURGICAL CENTER,LLC, TEXAS HEALTH SURGERY CENTER ADDISON | 272248103 - (TX) NORTH DALLAS SURGICAL CENTERLLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59850 | $1955.00 | 1750347472 - BAYLOR SURGICARE AT NORTH DALLAS, LLC, BAYLOR SCOTT & WHITE SURGICARE-NORTH DALLAS | 752900902 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59850 | $1274.00 | 1225579295 - SANTA BARBARA OUTPATIENT SURGERY CENTERS LLC, SANTA BARBARA SURGERY CENTER | 371846158 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59850 | $572.00 | 1508863242 - BUFFALO SURGERY CENTER LLC | 161574540 - (NY) BUFFALO SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59850 | $1274.00 | 1275870537 - GCSA AMBULATORY SURGERY CENTER, LLC | 611699459 - (TX) GCSA AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59850 | $1413.00 | 1821194754 - COASTAL SURGICAL SPECIALISTS, INC. | 743000596 - (CA) COASTAL SURGICAL INSTITUTE | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59850 | $520.00 | 1306963020 - BATTLE CREEK ENDOSCOPY & SURGERY LLC | 201914507 - (MI) BATTLE CREEK ENDOSCOPY & SURGERY CENTER PLLC | MI | 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 59850 vs. Other Surgical Procedures for Maternity Care and Delivery Codes
The CPT 59850 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 59850 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 |
|---|---|---|
| 59850-CPT | Moderate | Induced Abortion, By 1 Or More Intra-Amniotic Injections (Amniocentesis-Injections), Including Hospital Admission And Visits, Delivery Of Fetus And Secundines; |
| 59851-CPT | Moderate | Induced Abortion, By 1 Or More Intra-Amniotic Injections (Amniocentesis-Injections), Including Hospital Admission And Visits, Delivery Of Fetus And Secundines; With Dilation And Curettage And/Or Evacuation |
| 59852-CPT | Moderate | Induced Abortion, By 1 Or More Intra-Amniotic Injections (Amniocentesis-Injections), Including Hospital Admission And Visits, Delivery Of Fetus And Secundines; With Hysterotomy (Failed Intra-Amniotic Injection) |
| 59856-CPT | Moderate | Induced Abortion, By 1 Or More Vaginal Suppositories (Eg, Prostaglandin) With Or Without Cervical Dilation (Eg, Laminaria), Including Hospital Admission And Visits, Delivery Of Fetus And Secundines; With Dilation And Curettage And/Or Evacuation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 59850. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 59850 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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