CPT code 59618: Attempted VBAC, complete care, cesarean outcome2026 Medicare rate & RVUs in Arizona
Report 59618 when an obstetrician or qualified practitioner manages antepartum, cesarean, and postpartum care after a trial of labor following prior cesarean ends in cesarean delivery.
In Arizona, Medicare pays $2,415.50 for 59618 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 59618 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 59618 covers
Code 59618 represents the complete maternity-care package when a patient with a prior cesarean undertakes labor for a vaginal birth, but delivery is by cesarean. It encompasses the practitioner’s antepartum management, cesarean delivery, and postpartum care. It is generally reported by the obstetrician or group responsible for the full course of care, rather than as a delivery-only service when that practitioner provided the package.
Documentation should support the prior cesarean, attempted vaginal labor, cesarean outcome, and practitioner responsibility for antepartum and postpartum care. Choose this code instead of the complete-care code for a successful VBAC when the trial ends in cesarean; use a delivery-only or postpartum-only sibling when only that portion is furnished. CMS identifies this as a maternity code, so the usual global surgery rules do not apply. When multiple procedures are performed in the same session, CMS’s standard reduction pays the highest-valued procedure in full and other procedures at 50%.
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 Arizona compares for 59618
Across 109 of 109 payment localities, the facility rate for 59618 runs from $2,163.64 in Wisconsin to $3,209.98 in Miami, FL. Arizona pays $2,415.50. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Arizona · this page$2,415.50
- Los Angeles, CA · California$2,529.20+$113.70
- Washington, DC area · District of Columbia$2,744.28+$328.78
- Miami, FL · Florida$3,209.98+$794.48
- Chicago, IL · Illinois$3,091.31+$675.81
- Manhattan, NY · New York$2,958.59+$543.09
- Alaska · Alaska$3,037.54+$622.04
Other areas in Arizona first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $2,223.51 |
| ArkansasArkansas | — | $2,190.11 |
| Bakersfield, CACalifornia | — | $2,416.20 |
| Chico, CACalifornia | — | $2,380.85 |
| El Centro, CACalifornia | — | $2,383.08 |
| Fresno, CACalifornia | — | $2,380.85 |
| Hanford, CACalifornia | — | $2,380.85 |
| Madera, CACalifornia | — | $2,380.85 |
| Merced, CACalifornia | — | $2,380.85 |
| Modesto, CACalifornia | — | $2,380.85 |
| Napa, CACalifornia | — | $2,580.00 |
| Oxnard, CACalifornia | — | $2,492.19 |
| Redding, CACalifornia | — | $2,380.85 |
| Rest of CaliforniaCalifornia | — | $2,380.85 |
| Riverside, CACalifornia | — | $2,523.69 |
| Sacramento, CACalifornia | — | $2,451.83 |
| Salinas, CACalifornia | — | $2,442.22 |
| San Diego, CACalifornia | — | $2,468.14 |
| Marin County, CACalifornia | — | $2,663.81 |
| San Francisco, CACalifornia | — | $2,648.64 |
| San Benito County, CACalifornia | — | $2,740.30 |
| Santa Clara County, CACalifornia | — | $2,678.27 |
| San Luis Obispo, CACalifornia | — | $2,409.47 |
| Santa Cruz, CACalifornia | — | $2,465.62 |
| Santa Maria, CACalifornia | — | $2,442.72 |
| Santa Rosa, CACalifornia | — | $2,486.77 |
| Stockton, CACalifornia | — | $2,380.85 |
| Vallejo, CACalifornia | — | $2,558.14 |
| Visalia, CACalifornia | — | $2,380.85 |
| Yuba City, CACalifornia | — | $2,380.85 |
| ColoradoColorado | — | $2,461.93 |
| ConnecticutConnecticut | — | $2,673.13 |
| DelawareDelaware | — | $2,454.28 |
| Fort Lauderdale, FLFlorida | — | $2,869.60 |
| Rest of FloridaFlorida | — | $2,695.56 |
| Atlanta, GAGeorgia | — | $2,604.90 |
| Rest of GeorgiaGeorgia | — | $2,514.18 |
| Hawaii, Guam, HIHawaii | — | $2,403.72 |
| IowaIowa | — | $2,174.73 |
| IdahoIdaho | — | $2,211.97 |
| East St. Louis, ILIllinois | — | $2,899.62 |
| Rest of IllinoisIllinois | — | $2,693.71 |
| Suburban Chicago, ILIllinois | — | $2,872.58 |
| IndianaIndiana | — | $2,222.43 |
| KansasKansas | — | $2,215.15 |
| KentuckyKentucky | — | $2,388.57 |
| New Orleans, LALouisiana | — | $2,521.80 |
| Rest of LouisianaLouisiana | — | $2,405.10 |
| Metropolitan Boston, MAMassachusetts | — | $2,637.37 |
| Rest of MassachusettsMassachusetts | — | $2,467.30 |
| Baltimore area, MDMaryland | — | $2,676.96 |
| Rest of MarylandMaryland | — | $2,485.67 |
| Rest of MaineMaine | — | $2,278.46 |
| Southern Maine, MEMaine | — | $2,329.74 |
| Detroit, MIMichigan | — | $2,783.21 |
| Rest of MichiganMichigan | — | $2,500.04 |
| MinnesotaMinnesota | — | $2,205.55 |
| Metropolitan Kansas City, MOMissouri | — | $2,449.52 |
| Metropolitan St. Louis, MOMissouri | — | $2,469.33 |
| Rest of MissouriMissouri | — | $2,396.93 |
| MississippiMississippi | — | $2,291.39 |
| MontanaMontana | — | $2,499.50 |
| North CarolinaNorth Carolina | — | $2,294.70 |
| North DakotaNorth Dakota | — | $2,235.33 |
| NebraskaNebraska | — | $2,171.58 |
| New HampshireNew Hampshire | — | $2,471.90 |
| Northern New JerseyNew Jersey | — | $2,724.72 |
| Rest of New JerseyNew Jersey | — | $2,660.46 |
| New MexicoNew Mexico | — | $2,534.83 |
| NevadaNevada | — | $2,426.54 |
| NYC suburbs and Long Island, NYNew York | — | $3,097.49 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $2,719.82 |
| Queens, NYNew York | — | $2,907.64 |
| Rest of New YorkNew York | — | $2,334.58 |
| OhioOhio | — | $2,446.05 |
| OklahomaOklahoma | — | $2,329.65 |
| Portland, OROregon | — | $2,482.26 |
| Rest of OregonOregon | — | $2,365.20 |
| Metropolitan Philadelphia, PAPennsylvania | — | $2,638.80 |
| Rest of PennsylvaniaPennsylvania | — | $2,421.26 |
| Puerto RicoPuerto Rico | — | $2,501.02 |
| Rhode IslandRhode Island | — | $2,500.55 |
| South CarolinaSouth Carolina | — | $2,382.86 |
| South DakotaSouth Dakota | — | $2,204.09 |
| TennesseeTennessee | — | $2,233.21 |
| Austin, TXTexas | — | $2,490.91 |
| Beaumont, TXTexas | — | $2,408.80 |
| Brazoria, TXTexas | — | $2,407.34 |
| Dallas, TXTexas | — | $2,446.86 |
| Fort Worth, TXTexas | — | $2,446.00 |
| Galveston, TXTexas | — | $2,430.09 |
| Houston, TXTexas | — | $2,674.62 |
| Rest of TexasTexas | — | $2,423.16 |
| UtahUtah | — | $2,414.93 |
| VirginiaVirginia | — | $2,357.88 |
| Virgin Islands, VIUnited States Virgin Islands | — | $2,501.02 |
| VermontVermont | — | $2,273.29 |
| Rest of WashingtonWashington | — | $2,447.07 |
| King County, WAWashington | — | $2,639.26 |
| WisconsinWisconsin | — | $2,163.64 |
| West VirginiaWest Virginia | — | $2,605.52 |
| WyomingWyoming | — | $2,384.37 |
59618 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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 59618 rate is calculated
Each of 59618’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 · 59618
RVUs × geographic indexes × conversion factor
Work41.57
41.57 RVUs× 1.000 GPCI
Practice expense19.93
19.93 RVUs× 1.000 GPCI
Malpractice13.36
13.36 RVUs× 1.000 GPCI
Adjusted RVUs
74.8600
Conversion factor
$33.4009
Medicare rate
$2,500.39
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Arizona inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
6,670
- Code
- 59618
- Physician work
- 41.57
- Practice expense
- 19.93
- Malpractice
- 13.36
GPCI2026.csv
6
- Locality
- Arizona
- Physician work
- 1.000
- Practice expense
- 0.969
- Malpractice
- 0.856
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 41.57 | × 1.000 | 41.5700 |
| Practice expense | 19.93 | × 0.969 | 19.3122 |
| Malpractice | 13.36 | × 0.856 | 11.4362 |
| Total RVUs | 72.3183 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Arizona$2415.50
Facility: (41.57 × 1 + 19.93 × 0.969 + 13.36 × 0.856) × $33.4009 = $2415.50
Payment rules and modifiers for 59618
The CMS indicators that decide how 59618 is paid alongside other services.
CMS payment indicators · 59618
Attempted VBAC, complete care, cesarean outcome
| Rule | CMS value | What it means |
|---|---|---|
| Global period | MMM | Maternity care: global rules don’t follow the standard pattern. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
59618 without 51 · national facility
$2,500.39
Attempted VBAC, complete care, cesarean outcome
59618-51 · Second procedure: 50%
$1,250.20
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%).
How 59618 has changed in Arizona
59618 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $2,415.50 | RVU26D |
| 2026-07-01 | Not available in this setting | $2,415.50 | RVU26C |
| 2026-04-01 | Not available in this setting | $2,415.50 | RVU26B |
| 2026-01-01 | Not available in this setting | $2,415.50 | RVU26A |
| 2025-10-01 | Not available in this setting | $2,562.56 | RVU25D |
| 2025-07-01 | Not available in this setting | $2,562.56 | RVU25C |
| 2025-04-01 | Not available in this setting | $2,562.56 | RVU25B |
| 2025-01-01 | Not available in this setting | $2,562.56 | RVU25A |
| 2024-10-01 | Not available in this setting | $2,645.75 | RVU24D |
| 2024-07-01 | Not available in this setting | $2,645.75 | RVU24C |
| 2024-04-01 | Not available in this setting | $2,645.75 | RVU24B |
| 2024-03-09 | Not available in this setting | $2,645.75 | RVU24AR |
| 2024-01-01 | Not available in this setting | $2,602.57 | RVU24A |
| 2023-10-01 | Not available in this setting | $2,629.64 | RVU23D |
| 2023-07-01 | Not available in this setting | $2,629.64 | RVU23C |
| 2023-04-01 | Not available in this setting | $2,629.64 | RVU23B |
| 2023-01-01 | Not available in this setting | $2,629.64 | RVU23A |
| 2022-10-01 | Not available in this setting | $2,641.94 | RVU22D |
| 2022-07-01 | Not available in this setting | $2,641.94 | RVU22C |
| 2022-04-01 | Not available in this setting | $2,641.94 | RVU22B |
| 2022-01-01 | Not available in this setting | $2,641.94 | RVU22A |
| 2021-10-01 | Not available in this setting | $2,635.89 | RVU21D |
| 2021-07-01 | Not available in this setting | $2,635.89 | RVU21C |
| 2021-04-01 | Not available in this setting | $2,635.89 | RVU21B |
| 2021-01-01 | Not available in this setting | $2,635.89 | RVU21A |
| 2020-10-01 | Not available in this setting | $2,406.58 | RVU20D |
| 2020-07-01 | Not available in this setting | $2,406.58 | RVU20C |
| 2020-04-01 | Not available in this setting | $2,406.58 | RVU20B |
| 2020-01-01 | Not available in this setting | $2,406.58 | RVU20A |
| 2019-10-01 | Not available in this setting | $2,367.12 | RVU19D |
| 2019-07-01 | Not available in this setting | $2,367.12 | RVU19C |
| 2019-04-01 | Not available in this setting | $2,367.12 | RVU19B |
| 2019-01-01 | Not available in this setting | $2,367.12 | RVU19A |
| 2018-10-01 | Not available in this setting | $2,345.64 | RVU18D |
| 2018-07-01 | Not available in this setting | $2,345.64 | RVU18C |
| 2018-04-01 | Not available in this setting | $2,345.64 | RVU18B |
| 2018-01-01 | Not available in this setting | $2,345.64 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $2,374.46 | RVU17D |
| 2017-07-01 | Not available in this setting | $2,374.46 | RVU17C |
| 2017-04-01 | Not available in this setting | $2,374.46 | RVU17B |
| 2017-01-01 | Not available in this setting | $2,374.46 | RVU17A |
| 2016-10-01 | Not available in this setting | $2,382.73 | RVU16D |
| 2016-07-01 | Not available in this setting | $2,382.73 | RVU16C |
| 2016-04-01 | Not available in this setting | $2,382.73 | RVU16B |
| 2016-01-01 | Not available in this setting | $2,382.73 | RVU16A |
| 2015-10-01 | Not available in this setting | $2,397.54 | RVU15D |
| 2015-07-01 | Not available in this setting | $2,397.54 | RVU15C |
| 2015-04-01 | Not available in this setting | $2,385.61 | RVU15B |
| 2015-01-01 | Not available in this setting | $2,385.61 | RVU15A |
| 2014-10-01 | Not available in this setting | $2,419.77 | RVU14D |
| 2014-07-01 | Not available in this setting | $2,419.77 | RVU14C |
| 2014-04-01 | Not available in this setting | $2,419.77 | RVU14B |
| 2014-01-01 | Not available in this setting | $2,419.77 | RVU14A |
| 2013-10-01 | Not available in this setting | $2,396.32 | RVU13D |
| 2013-07-01 | Not available in this setting | $2,396.32 | RVU13C |
| 2013-04-01 | Not available in this setting | $2,396.32 | RVU13B |
| 2013-01-01 | Not available in this setting | $2,396.32 | RVU13AR |
Where the Arizona rate applies
Arizona is a Medicare payment area, not a city. Our Census mapping connects it to 467 cities and communities in Arizona. Some span more than one payment area; confirm with the service ZIP.
- Aguila
- Ajo
- Ak Chin
- Ak-Chin Village
- Alamo Lake
- Ali Chuk
- Ali Chukson
- Ali Molina
59618 billing questions
Does 59618 include antepartum and postpartum care?
Yes. It represents the complete maternity-care package, including antepartum care, cesarean delivery after an attempted VBAC, and postpartum care.
Which code applies if the attempted VBAC succeeds?
For the complete maternity-care package when vaginal delivery follows the prior cesarean, use 59610 rather than 59618.
When should 59620 be used instead?
Use 59620 for the cesarean delivery only after an attempted VBAC when the service is limited to delivery, rather than the complete care package represented by 59618.
How does the multiple procedure reduction affect 59618?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50% under the standard reduction.
Does the usual global surgery rule apply to this maternity code?
No. CMS identifies 59618 as a maternity code, for which the usual global surgery rules do not apply.
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
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