| CPT Code | Description | Physician Charge | Medicaid Reimbursement |
|---|---|---|---|
| 54900 | Delivery | $2760 | $1390 |
| 59510–80 | Assist at cesarean delivery | $911 | $0 |
| 58120 | Dilatation & curettage | $549 | $170 |
| 57522 | LEEP | $693 | $176 |
| 57520 | Cervical conization | $723 | $211 |
| 57511 | Cryotherapy cervix | $172 | $99 |
| 57454 | Colposcopy/biopsies | $225 | $108 |
| 58100 | Endometrial biopsy | $139 | $76 |
| J7307 | Implanon/Nexplanon placement | $874 | $659 |
| J7302 | Mirena placement | $899 | $703 |
| J7300 | Paragard placement | $750 | $598 |
| 58605 | Postpartum tubal ligation | $931 | $432 |
| 56420 | I&D Bartholin gland abscess | $160 | $94.50 |
| 54161 | Newborn circumcision | $254 | $172 |
| — | Ultrasound* | $150 | $100 |
↵* $100 for providing ultrasounds regardless of how many are performed.
CPT, current procedural terminology; I&D, incision and drainage; LEEP, loop electrosurgical excision procedure.