CPT 59425: Partial Antepartum Care (Mini-Global)
Medicare pays $583 and commercial payers pay $618 on average nationally for this procedure.
CPT code 59425 describes a mini-global obstetric service for a provider who delivers only four to six antepartum visits when full antepartum care is not provided (for example, when a patient transfers care or pregnancy terminates prior to delivery); the service type is partial antepartum care / mini-global obstetric service and the typical site of service is office or outpatient obstetrics clinic where antepartum visits and coordination of delivery-related care occur.
For related coverage guidance, see recent payer policy updates: Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders.
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National Reimbursement Benchmarks
Medicare’s national mean of $582.80 sits below BUCA’s average commercial mean of $618.20 for CPT 59425, indicating BUCA pays modestly higher on average than Medicare by $35.40. Blue Cross Blue Shield and Aetna have means of $572.70 and $513.50 respectively, while Cigna and UnitedHealth Group show substantially higher means at $743.10 and $734.20, reflecting a wide spread in commercial payer averages around the Medicare baseline.
Dispersion measured as the interquartile distance (P75 minus P25) highlights variability across payers: Cigna’s IQR is $482.20 (from $478.30 to $906.50) and UnitedHealth Group’s IQR is $462.90 (from $463.40 to $926.30), representing the widest ranges among listed payers. Aetna’s IQR is $281.20 and Blue Cross Blue Shield’s is $153.10, making BCBS the tightest of those with full quartile data; BUCA’s IQR is $345.60 and Medicare’s IQR is $50.00, indicating Medicare payments are relatively concentrated around its central tendency.