CPT code 59400: Maternity care, antepartum, delivery, postpartum2026 Medicare rate & RVUs in Washington, DC area

Report this maternity package when one clinician or group provides routine prenatal care, vaginal delivery, and routine postpartum care for the pregnancy.

CMS RVU26DEffective Oct 1, 2026One payment locality1.2K Medicare services in 2024

In Washington, DC area, Medicare pays $2,432.53 for 59400 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$2,432.53Hospital or facility

Check a contract rate as a % of Medicare · 59400 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 59400 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 59400 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 59400 covers

This package represents routine care across pregnancy, vaginal birth, and the postpartum period. It includes prenatal management and a vaginal delivery, with or without episiotomy or forceps, followed by routine postpartum care. It is typically furnished by an obstetrician or another qualified maternity-care clinician in an office and hospital setting. The delivery component is for vaginal birth, not cesarean delivery.

Report 59400 when the same clinician or group furnishes all three components. The record should support the antepartum care, delivery, and postpartum services provided; when care is divided, report the applicable components rather than the complete package. CMS treats this as a maternity code, so the usual global surgery rules do not apply. If qualifying procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50% under the standard multiple procedure reduction.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Washington, DC area compares for 59400

Across 109 of 109 payment localities, the facility rate for 59400 runs from $1,944.55 in Wisconsin to $2,778.45 in Miami, FL. Washington, DC area pays $2,432.53. The RVUs are the same everywhere; the geographic indexes change the dollars.

59400 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$2,432.53
  2. Los Angeles, CA · California$2,261.53−$171.00
  3. Miami, FL · Florida$2,778.45+$345.92
  4. Chicago, IL · Illinois$2,682.16+$249.63
  5. Manhattan, NY · New York$2,601.38+$168.85
  6. Alaska · Alaska$2,715.06+$282.53
  7. Alabama · Alabama$1,983.37−$449.16

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

59400 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas—$1,955.39
ArizonaArizona—$2,144.36
Bakersfield, CACalifornia—$2,160.46
Chico, CACalifornia—$2,132.29
El Centro, CACalifornia—$2,134.05
Fresno, CACalifornia—$2,132.29
Hanford, CACalifornia—$2,132.29
Madera, CACalifornia—$2,132.29

59400 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
59400 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 59400 in every payment locality

How the 59400 rate is calculated

Each of 59400’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 59400

RVUs × geographic indexes × conversion factor

Office or facility?

Work37.00

37.00 RVUs× 1.000 GPCI

Practice expense18.76

18.76 RVUs× 1.000 GPCI

Malpractice10.54

10.54 RVUs× 1.000 GPCI

Adjusted RVUs

66.3000

Conversion factor

$33.4009

Medicare rate

$2,214.48

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,655

Code
59400
Physician work
37.00
Practice expense
18.76
Malpractice
10.54

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Facility calculation for 59400 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work37.00× 1.05438.9980
Practice expense18.76× 1.17822.0993
Malpractice10.54× 1.11311.7310
Total RVUs72.8283
Conversion factor× 33.4009

Facility rate, Washington, DC area$2432.53

Facility: (37 × 1.054 + 18.76 × 1.178 + 10.54 × 1.113) × $33.4009 = $2432.53

Open 59400 in the RVU calculator

Payment rules and modifiers for 59400

The CMS indicators that decide how 59400 is paid alongside other services.

CMS payment indicators · 59400

Maternity care, antepartum, delivery, postpartum

RuleCMS valueWhat it means
Global periodMMMMaternity care: global rules don’t follow the standard pattern.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

59400 without 51 · national facility

$2,214.48

Maternity care, antepartum, delivery, postpartum

59400-51 · Second procedure: 50%

$1,107.24

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

How 59400 has changed in Washington, DC area

59400 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$2,432.53RVU26D
2026-07-01Not available in this setting$2,432.53RVU26C
2026-04-01Not available in this setting$2,432.53RVU26B
2026-01-01Not available in this setting$2,432.53RVU26A
2025-10-01Not available in this setting$2,638.34RVU25D
2025-07-01Not available in this setting$2,638.34RVU25C
2025-04-01Not available in this setting$2,638.34RVU25B
2025-01-01Not available in this setting$2,638.34RVU25A
2024-10-01Not available in this setting$2,722.13RVU24D
2024-07-01Not available in this setting$2,722.13RVU24C
2024-04-01Not available in this setting$2,722.13RVU24B
2024-03-09Not available in this setting$2,722.13RVU24AR
2024-01-01Not available in this setting$2,677.70RVU24A
2023-10-01Not available in this setting$2,766.88RVU23D
2023-07-01Not available in this setting$2,766.88RVU23C
2023-04-01Not available in this setting$2,766.88RVU23B
2023-01-01Not available in this setting$2,766.88RVU23A
2022-10-01Not available in this setting$2,829.49RVU22D
2022-07-01Not available in this setting$2,829.49RVU22C
2022-04-01Not available in this setting$2,829.49RVU22B
2022-01-01Not available in this setting$2,829.49RVU22A
2021-10-01Not available in this setting$2,816.64RVU21D
2021-07-01Not available in this setting$2,816.64RVU21C
2021-04-01Not available in this setting$2,816.64RVU21B
2021-01-01Not available in this setting$2,816.64RVU21A
2020-10-01Not available in this setting$2,528.14RVU20D
2020-07-01Not available in this setting$2,528.14RVU20C
2020-04-01Not available in this setting$2,528.14RVU20B
2020-01-01Not available in this setting$2,528.14RVU20A
2019-10-01Not available in this setting$2,454.34RVU19D
2019-07-01Not available in this setting$2,454.34RVU19C
2019-04-01Not available in this setting$2,454.34RVU19B
2019-01-01Not available in this setting$2,454.34RVU19A
2018-10-01Not available in this setting$2,429.42RVU18D
2018-07-01Not available in this setting$2,429.42RVU18C
2018-04-01Not available in this setting$2,429.42RVU18B
2018-01-01Not available in this setting$2,429.42RVU18AR1
2017-10-01Not available in this setting$2,443.87RVU17D
2017-07-01Not available in this setting$2,443.87RVU17C
2017-04-01Not available in this setting$2,443.87RVU17B
2017-01-01Not available in this setting$2,443.87RVU17A
2016-10-01Not available in this setting$2,439.55RVU16D
2016-07-01Not available in this setting$2,439.55RVU16C
2016-04-01Not available in this setting$2,439.55RVU16B
2016-01-01Not available in this setting$2,439.55RVU16A
2015-10-01Not available in this setting$2,469.11RVU15D
2015-07-01Not available in this setting$2,469.11RVU15C
2015-04-01Not available in this setting$2,456.82RVU15B
2015-01-01Not available in this setting$2,456.82RVU15A
2014-10-01Not available in this setting$2,450.68RVU14D
2014-07-01Not available in this setting$2,450.68RVU14C
2014-04-01Not available in this setting$2,450.68RVU14B
2014-01-01Not available in this setting$2,450.68RVU14A
2013-10-01Not available in this setting$2,392.65RVU13D
2013-07-01Not available in this setting$2,392.65RVU13C
2013-04-01Not available in this setting$2,392.65RVU13B
2013-01-01Not available in this setting$2,392.65RVU13AR

Price 59400 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

59400 billing questions

When should 59400 be used instead of 59409?

Use 59400 when the clinician or group provides routine antepartum care, vaginal delivery, and postpartum care. Code 59409 is for the vaginal delivery component only.

Can 59400 be reported if another clinician provided postpartum care?

No. The complete package represents all three components; when care is divided, report the applicable services furnished by each clinician or group.

Does 59400 include forceps or episiotomy during vaginal delivery?

The vaginal delivery component includes delivery with or without forceps or episiotomy. The package also includes routine antepartum and postpartum care.

How does CMS apply the global surgery rules to 59400?

59400 is a maternity code, and the usual global surgery rules do not apply. Its package is defined by the obstetric care furnished across pregnancy, delivery, and postpartum care.

What happens if another procedure is performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other qualifying procedures are paid at 50%.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 59400PPRRVU2026_Oct_nonQPP.csv, line 6,655 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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