CPT 59514 Reimbursement Benchmarks

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National Reimbursement Benchmarks

Nationally, Medicare's mean rate of $819.80 sits below BUCA's average commercial mean of $1,120.20, indicating that commercial arrangements captured by BUCA pay about $300 higher on average than Medicare for CPT 59514. UnitedHealth Group and Cigna have the highest mean levels at $1,515.80 and $1,435.30 respectively, while Aetna and Blue Cross Blue Shield are lower on mean but still above Medicare in many cases.

Dispersion measured as the interquartile range (P75 minus P25) is widest for Cigna at $896.00 (from $903.20 to $1,828.00) and for UnitedHealth Group at $847.70 (from $1,007.30 to $1,855.00), indicating greater variability in commercial pricing there. The tightest spreads are with Medicare at $74.00 (from $770 to $844) and Aetna at $475.60 (from $258.70 to $1,063.30), reflecting more compressed payment distributions for those payers.

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National Reimbursement Benchmarks

National Payer Mean Reimbursement Rates

Related Codes

CPT-59510-GLOBAL-CESAREAN-DELIVERY

CPT 59510: Global Cesarean Delivery Care

CPT-59515-CESAREAN-DELIVERY-GLOBAL-SERVICE

CPT 59515: Cesarean Delivery, Global Service

CPT-59525-CESAREAN-DELIVERY-SUBTOTAL-HYSTERECTOMY

CPT 59525: Cesarean Delivery with Subtotal (Partial) Hysterectomy

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Related Codes

CPT-59510-GLOBAL-CESAREAN-DELIVERY

CPT 59510: Global Cesarean Delivery Care

CPT-59515-CESAREAN-DELIVERY-GLOBAL-SERVICE

CPT 59515: Cesarean Delivery, Global Service

CPT-59525-CESAREAN-DELIVERY-SUBTOTAL-HYSTERECTOMY

CPT 59525: Cesarean Delivery with Subtotal (Partial) Hysterectomy

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

National Reimbursement Benchmarks

National Reimbursement Benchmarks

Related Codes

What does CPT 59514 specifically describe and what care does it exclude?

What are the reported mean reimbursement rates for CPT 59514 across major payers?

How much variability is there in payer reimbursements for CPT 59514?

How do commercial payer means compare to Medicare for CPT 59514?

Where is CPT 59514 typically performed and how is it categorized on this page?

References

Related Codes

What does CPT 59514 specifically describe and what care does it exclude?

What are the reported mean reimbursement rates for CPT 59514 across major payers?

How much variability is there in payer reimbursements for CPT 59514?

How do commercial payer means compare to Medicare for CPT 59514?

Where is CPT 59514 typically performed and how is it categorized on this page?

References