CPT 59852 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 | • 21 - Inpatient Hospital • 50 - Federally Qualified Health Center |
| Common Modifiers | • None • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
National average reimbursement for CPT 59852 by major payers:
$730.72
$729.87
$714.62
$922.84
| 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 59852 | ||||||
United | 59852 | $509.00 | 1508318411 - INTERVENTIONAL SPINE CENTER, LLC | 263161503 - (CA) INTERVENTIONAL SPINE CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59852 | $4893.00 | 1033586136 - PHYSICIANS WEST HOUSTON SURGICAL CENTER, LLC, MEMORIAL HERMANN SURGERY CENTER PARK TEN | 371789833 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59852 | $291.00 | 1083669196 - SPECIALTY ASC LLC, SURGICAL ARTS CENTER | 880503205 - (NV) SPECIALTY ASC LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59852 | $983.00 | 1649223124 - CAMP LOWELL SURGERY CENTER,LLC, CAMP LOWELL SURGERY CENTER | 201086556 - (AZ) CAMP LOWELL SURGERY CENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59852 | $525.00 | 1649668781 - NORTHERN ARIZONA HEALTHCARE ORTHOPEDIC SURGERY CENTER, LLC | 472572645 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59852 | $1955.00 | 1548238140 - DENTON SURGICARE PARTNERS LTD, BAYLOR SCOTT & WHITE SURGICARE - DENTON | 752708579 - (TX) DENTON SURGICARE PARTNERS LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59852 | $582.00 | 1972208379 - HIGH RESORT EYE SURGERY CENTER LLC | 923159505 - (NM) HIGH RESORT EYE SURGERY CENTER LLC | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59852 | $395.00 | 1205373057 - BAY AREA ASC LLC, AZURA SURGERY CENTER HOUSTON | 814821022 - (TX) BAY AREA ASC LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59852 | $1049.00 | 1831180272 - ADVANCED ENDOSCOPY CENTER LLC | 861083384 - (MO) ADVANCED ENDOSCOPY CENTER, LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59852 | $476.00 | 1902863723 - OAK & MAIN SURGICENTER LLC | 223532371 - (NJ) OAK MAIN SURGICENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59852 | $1559.00 | 1427049352 - CENTER FOR AMBULATORY SURGERY, LLC, THE CENTER FOR AMBULATORY SURGERY | 223638149 - (NJ) THE CENTER FOR AMBULATORY SURGERY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59852 | $6068.00 | 1982716106 - THR/STT SOUTHLAKE ASC, LLC | 262429878 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59852 | $1271.00 | 1982672283 - ROSEVILLE SURGERY CENTER, LP, ROSEVILLE SURGERY CENTER | 202468557 - (CA) ROSEVILLE SURGERY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59852 | $555.00 | 1477559839 - SURGERY CENTER OF NORTHERN COLORADO, EYE CENTER OF NORTHEN COLORADO SURGERY CENTER | 841420378 - (CO) SURGERY CENTER OF NORTHERN COLORADO | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59852 | $363.00 | 1508839473 - NEWARK ENDOSCOPY ASC LLC, ENDOSCOPY CENTER OF DELAWARE | 621867825 - (DE) NEWARK ENDOSCOPY ASC LLC | DE | 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 59852 vs. Other Surgical Procedures for Maternity Care and Delivery Codes
The CPT 59852 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 59852 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 59852. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 59852 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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