Summary & Overview
CPT 59300: Episiotomy (Perineal Incision) During Vaginal Delivery
CPT code 59300 represents an episiotomy performed by a provider other than the attending physician to facilitate delivery of the infant by incising the perineum. As an obstetric procedure performed during labor and vaginal birth, it is relevant to maternal care pathways, facility billing on labor and delivery service lines, and peri-delivery quality and documentation standards. Nationally, episiotomy rates and appropriate coding affect clinical quality reporting, provider billing, and payment consistency across payers.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find an overview of what this code denotes clinically, how it maps to service lines and sites of service, commonly observed modifiers, and where gaps in input data exist. The publication summarizes benchmark considerations, typical billing contexts for labor and delivery, and documentation elements that intersect with payer adjudication. Data not available in the input includes associated taxonomies, specific ICD-10 diagnosis pairings, and related codes.
This piece is intended for billing managers, obstetric service line leaders, and policy analysts seeking clear, national-level context for CPT code 59300 and its role in peripartum billing and clinical workflows.
Billing Code Overview
CPT code 59300 describes an episiotomy performed by a provider other than the attending physician, in which the provider incises the perineum with scissors or a scalpel to ease passage of the baby’s head during birth. This procedure is an obstetric perineal incision performed in the context of vaginal delivery.
Service type: Obstetric surgical procedure (episiotomy)
Typical site of service: Labor and delivery unit or obstetric operating room
Clinical & Coding Specifications
Clinical Context
A 28-year-old G1P0 woman at 39 weeks’ gestation presents in active labor with fetal head descent to +2 station. Maternal exhaustion and an occiput posterior fetal position are noted; progress of the second stage is prolonged despite adequate maternal effort and epidural anesthesia. The delivering clinician, not the attending obstetrician but an authorized provider in the delivery suite (for example, a labor and delivery nurse practitioner or obstetric physician assistant), performs a therapeutic episiotomy to enlarge the perineal outlet and expedite delivery of the fetal head to reduce maternal soft-tissue trauma and avoid severe perineal laceration.
Clinical workflow: upon determination of protracted second stage and indication for perineal incision, informed consent is obtained from the patient (when feasible), maternal vital signs and fetal monitoring are confirmed, sterile preparation is performed, local anesthetic is administered if needed, and the provider performs a medio-lateral episiotomy with scissors or scalpel. After delivery, the provider inspects the perineum, controls bleeding, and performs layered repair of the episiotomy. Documentation includes indication for the episiotomy, who performed the incision (provider name and taxonomy), technique, laterality/direction of incision, anesthesia used, estimated blood loss, and repair details.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the episiotomy required substantially greater effort, time, or technical difficulty than typical. |