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 |
| Medicare Fee Schedule | View Medicare rates for 59852 |
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 | $1306.00 | 1164513149 - ENDO-SURGI OF UNION ASC LLC | 223248249 - (NJ) ENDO-SURGI CENTER, P.A. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59852 | $475.00 | 1881193183 - SOUTHSIDE SPECIALTY SURGICAL CENTER LLC | 823920550 - (TX) SOUTHSIDE SPECIALTY SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59852 | $555.00 | 1063427706 - PROHEALTH AMBULATORY SURGERY CENTER INC | 113447394 - (NY) PROHEALTH AMBULATORY SURGERY CENTER INC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59852 | $398.00 | 1033426580 - ADVANCED AMBULATORY SURGERY CENTER, LLC | 271607092 - (IN) ADVANCED AMBULATORY SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59852 | $1064.00 | 1265972087 - GOLDEN RIDGE ASC, LLC, GOLDEN RIDGE SURGERY CENTER | 820602141 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59852 | $410.00 | 1053634030 - DALLAS NEPHROLOGY ASSOCIATES, DALLAS NEPHROLOGY ASSOCIATES VASCULAR CENTER DALLAS | 751366650 - (TX) DALLAS NEPHROLOGY ASSOCIATES, P.A. | TX | 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 | $700.00 | 1689326670 - PRISMA HEALTH AMBULATORY SURGERY CENTERS-MIDLANDS, LLC, PRISMA HEALTH ORTHOPEDIC SURGERY CENTER | 873101776 - (SC) PRISMA HEALTH AMBULATORY SURGERY CENTERSMIDLANDS LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59852 | $1000.00 | 1396089108 - TRIANGLE ORTHOPAEDICS SURGERY CENTER | 275268935 - (NC) TRIANGLE ORTHOPAEDICS SURGERY CENTER | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59852 | $1310.00 | 1912909169 - KIPS BAY ENDOSCOPY CENTER, LLC | 134243635 - (NY) KIPS BAY ENDOSCOPY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59852 | $106.00 | 1447231287 - GASTROENTEROLOGY SPECIALISTS INC, ENDOSCOPY CENTER | 341773267 - (OH) GASTROENTEROLOGY SPECIALISTS, INC. | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59852 | $509.00 | 1508318411 - INTERVENTIONAL SPINE CENTER, LLC | 263161503 - (CA) INTERVENTIONAL SPINE CENTER LLC | CA | 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 | $1477.00 | 1437191731 - EL DORADO SURGERY CENTER LP, TUCSON SURGERY CENTER | 850474225 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59852 | $440.00 | 1831636752 - RIVER VIEW SURGERY CENTER, LLC | 814790945 - (ID) RIVER VIEW SURGERY CENTER, LLC | ID | 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 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 59852) and we'll show you how you compare in 15 minutes or less.