CPT 59870 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 • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 59870 |
National average reimbursement for CPT 59870 by major payers:
$609.10
$648.74
$682.09
$836.46
| 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 59870 | ||||||
United | 59870 | $2941.00 | 1295790327 - ENDOSCOPY OF PLANO, LP, GASTROINTESTINAL ENDOSCOPY CENTER OF PLANO | 201477775 - (TX) ENDOSCOPY OF PLANO LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59870 | $2388.00 | 1265534556 - SOUTH FLORIDA AMBULATORY SURGICAL CENTER LLC | 651093026 - (FL) SOUTH FLORIDA AMBULATORY SURGI | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59870 | $1870.00 | 1649252883 - FOUNDATION SURGERY AFFILIATE OF NACOGDOCHES LLC, NACOGDOCHES SURGERY CENTER | 731589339 - (TX) FOUNDATION SURGERY AFFILIATE OF NACOGDOCHES LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59870 | $1414.00 | 1609815075 - ORTHOATLANTA SURGERY CENTER OF FAYETTEVILLE, LLC | 202961633 - (GA) ORTHOATLANTA SURGERY CENTER OF FAYETTEVILLE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59870 | $2822.00 | 1821141284 - CENTER FOR HEALTH AMBULATORY SURGERY CENTER, LLC | 205557171 - (IL) CENTER FOR HEALTH AMBULATORY SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59870 | $2388.00 | 1538390539 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59870 | $970.00 | 1568981975 - WEST MICHIGAN SURGICAL CENTER, LLC | 820593284 - (MI) WEST MICHIGAN SURGICAL CENTER, L | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59870 | $3319.00 | 1801199039 - HUNTINGTON AMBULATORY SURGERY CENTER, LLC | 273922007 - (CA) HUNTINGTON AMBULATORY SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59870 | $475.00 | 1962869446 - FAYETTEVILLE GASTROENTEROLOGY ENDOSCOPY CENTER, LLC | 473997859 - (NC) FAYETTEVILLE GASTROENTEROLOGY ENDOSCOPY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59870 | $2206.00 | 1306843222 - ST. JOSEPH'S OUTPATIENT SURGERY CENTER, LLC | 562332449 - (AZ) ST JOSEPHS OUTPATIENT SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59870 | $2388.00 | 1659793040 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59870 | $774.00 | 1891951885 - MISSISSIPPI EYE SURGERY CENTER, MISSISSIPPI EYE SURGERY CENTER FACILITY | 770619942 | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59870 | $900.00 | 1508531641 - ALLIANCE SURGERY CENTER AT SANDY SPRINGS LLC | 871977629 - (GA) ALLIANCE SURGERY CENTER AT SANDY SPRINGS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59870 | $6245.00 | 1154454460 - TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD | 751438726 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 59870 | $875.00 | 1033760723 - ADVANCED SURGERY CENTER OF OXFORD | 825522826 - (FL) OXFORD SURGERY CENTER | FL | 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 59870 vs. Other Surgical Procedures for Maternity Care and Delivery Codes
The CPT 59870 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 59870 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 |
|---|---|---|
| 59866-CPT | Moderate | Multifetal Pregnancy Reduction(S) (Mpr) |
| 59870-CPT | Moderate | Uterine Evac/Curet-Hydatidifrm Mole |
| 59871-CPT | Low | Removal Of Cerclage Suture Under Anesthesia (Other Than Local) |
| 59897-CPT | High | Unlisted Fetal Invasive Procedure, Including Ultrasound Guidance, When Performed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 59870. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 59870 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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