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See a sample rate comparisonCPT 59856 Fee Schedule
Last Verified: October 2026
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.
Induced Ab 1+Vag Supp D&C, 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
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures for Maternity Care and Delivery |
| Common Place of Service | 24 - Ambulatory Surgical Center 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None AA - Anesthesia by anesthesiologist GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 59856 |
| Medicaid Fee Schedule | View Medicaid rates for 59856 |
National average reimbursement for CPT 59856 by major payers:
$623.64
$655.36
$654.19
$788.95
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CPT 59856
5 of 25 sample ratesHigher to lower in this preview
Bay Area Surgicenter, LLC, Brandon Surgery Center
Bay Area Surgicenter LLC
$5,532.00Published rateEscnc LLC, Eye Surgery Center Of Northern California
Escnc LLC
$1,624.00Published rateAdvanced Surgery Center Of Metairie LLC
Advanced Surgery Center Of Metairie
$1,276.00Published rateEndoscopy Center Of Grand Junction LLC
$755.00Published rateSt. Lukes Surgical At The Villages, Inc
St Lukes Surgical At The Villages Inc
$350.00Published rate
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See a sample payer proposalCPT 59856 vs. Other Surgical Procedures for Maternity Care and Delivery Codes
The CPT 59856 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 59856 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 |
|---|---|---|
| 59855-CPT | Moderate | Induced Abortion By 1 Or More, 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 |
| 59856-CPT | Moderate | Induced Ab 1+Vag Supp D&C, 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 |
| 59857-CPT | Moderate | Induced Ab 1+Vag Supp Hyst, 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 Hysterotomy (Failed Medical Evacuation) |
| 59866-CPT | Moderate | Remove Embryo From Uterus, Selective Removal Of Developing Embryos From A Multiple Pregnancy. This Procedure Usually Is Related To In Vitro Fertilization Or Artificial Insemination. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 59856. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 59856 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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