CPT 59514: Cesarean Delivery, Inpatient Surgical Service
Medicare pays $820 and commercial payers pay $1120 on average nationally for this procedure.
CPT code 59514 describes inpatient surgical delivery where the provider admits the patient for cesarean delivery, performs the abdominal incision to deliver the fetus and placenta, and provides immediate post-delivery care on the same date of service; service type: cesarean delivery (inpatient surgical obstetric service); typical site of service: hospital inpatient setting on the date of delivery.
For related coverage guidance, see recent payer policy updates: Dental Anesthesia Services, Anesthesia Services for Interventional Pain Management Procedures in an Adult, General Anesthesia and Conscious Sedation Services.
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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.