CPT 59851 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 | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • AG - Primary physician • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
National average reimbursement for CPT 59851 by major payers:
$529.00
$540.52
$531.86
$681.98
| 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 59851 | ||||||
United | 59851 | $425.00 | 1518379205 - IPS ASC, LLC, GEMINI SURGERY CENTER | 465227049 - (OH) IPS ASC LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59851 | $816.00 | 1174073506 - WILSHIRE ENDOSCOPY CENTER LLC | 813966913 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59851 | $901.00 | 1790710390 - SOUTHWESTERN MEDICAL CENTER, LLC, MAGNA SURGICAL CENTER | 364212258 - (IL) SOUTHWESTERN MEDICAL CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59851 | $867.00 | 1700363611 - APOLLO AMBULATORY SURGERY CENTER, LLC | 830828395 - (MO) APOLLO AMBULATORY SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59851 | $973.00 | 1083659866 - ORTHOPAEDIC SURGERY CENTER OF SAN ANTONIO LP, FOUNDATION SURGERY AFFILIATE OF SAN ANTONIO LP | 742976746 - (TX) ORTHOPAEDIC SURGERY CENTER OF SAN ANTONIO LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59851 | $772.00 | 1518955897 - BONITA COMMUNITY HEALTH CENTER INC, BONITA SPRINGS HEALTH CENTER | 593544102 - (FL) BONITA COMMUNITY HEALTH CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59851 | $1049.00 | 1295479780 - ADVENTHEALTH SURGERY CENTER DAVENPORT LLC | 881811228 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59851 | $280.00 | 1487871331 - GYNEMED SURGICAL CENTER | 521921544 - (MD) GYNEMED SURGICAL CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59851 | $1049.00 | 1053764779 - SURGCENTER OF ST. LUCIE, LLC | 475425011 - (FL) SURGCENTER OF ST. LUCIE, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59851 | $894.00 | 1306589809 - CCRM FLORIDA LLC, CCRM FLORIDA | 873211160 - (FL) CCRM FLORIDA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59851 | $1028.00 | 1215548524 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59851 | $16050.00 | 1902052350 - SURGERY CENTER, LLC | 263169180 - (WI) THE SURGERY CENTER, LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59851 | $902.00 | 1982873352 - BAHAMAS SURGERY CENTER LLC | 208025178 - (CA) BAHAMAS SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59851 | $200.00 | 1962869826 - ENDOTECH, LLC | 472926864 - (AZ) ENDOTECH LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59851 | $150.00 | 1649376757 - ADS HEALTHCARE LLC, ADS AMBULATORY SURGERY CENTER | 481207671 - (KS) ADS HEALTHCARE LLC | KS | 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 59851 vs. Other Surgical Procedures for Maternity Care and Delivery Codes
The CPT 59851 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 59851 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 59851. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 59851 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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