CPT code 59618: Attempted VBAC, complete care, cesarean outcome2026 Medicare rate & RVUs in Connecticut

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.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Connecticut, Medicare pays $2,673.13 for 59618 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$2,673.13Hospital or facility

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.

We’ll open 59618 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 59618 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 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 Connecticut 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. Connecticut pays $2,673.13. The RVUs are the same everywhere; the geographic indexes change the dollars.

59618 in Connecticut vs other payment areas
  1. Connecticut · this page$2,673.13
  2. Los Angeles, CA · California$2,529.20−$143.93
  3. Washington, DC area · District of Columbia$2,744.28+$71.15
  4. Miami, FL · Florida$3,209.98+$536.85
  5. Chicago, IL · Illinois$3,091.31+$418.18
  6. Manhattan, NY · New York$2,958.59+$285.46
  7. Alaska · Alaska$3,037.54+$364.41

Other areas in Connecticut first, then benchmark localities. Bars start at $0.

Every other payment area

59618 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$2,223.51
ArkansasArkansas—$2,190.11
ArizonaArizona—$2,415.50
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

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
59618 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 59618 in every payment locality

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

Office or facility?

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 Connecticut 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

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Facility calculation for 59618 in Connecticut
ComponentRVULocality factorAdjusted
Physician work41.57× 1.02042.4014
Practice expense19.93× 1.07721.4646
Malpractice13.36× 1.21016.1656
Total RVUs80.0316
Conversion factor× 33.4009

Facility rate, Connecticut$2673.13

Facility: (41.57 × 1.02 + 19.93 × 1.077 + 13.36 × 1.21) × $33.4009 = $2673.13

Open 59618 in the RVU calculator

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

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)0Not paid without supporting documentation.
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

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%).

When to use modifier 51

How 59618 has changed in Connecticut

59618 · 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$2,673.13RVU26D
2026-07-01Not available in this setting$2,673.13RVU26C
2026-04-01Not available in this setting$2,673.13RVU26B
2026-01-01Not available in this setting$2,673.13RVU26A
2025-10-01Not available in this setting$2,839.42RVU25D
2025-07-01Not available in this setting$2,839.42RVU25C
2025-04-01Not available in this setting$2,839.42RVU25B
2025-01-01Not available in this setting$2,839.42RVU25A
2024-10-01Not available in this setting$2,933.29RVU24D
2024-07-01Not available in this setting$2,933.29RVU24C
2024-04-01Not available in this setting$2,933.29RVU24B
2024-03-09Not available in this setting$2,933.29RVU24AR
2024-01-01Not available in this setting$2,885.41RVU24A
2023-10-01Not available in this setting$2,888.62RVU23D
2023-07-01Not available in this setting$2,888.62RVU23C
2023-04-01Not available in this setting$2,888.62RVU23B
2023-01-01Not available in this setting$2,888.62RVU23A
2022-10-01Not available in this setting$2,876.07RVU22D
2022-07-01Not available in this setting$2,876.07RVU22C
2022-04-01Not available in this setting$2,876.07RVU22B
2022-01-01Not available in this setting$2,876.07RVU22A
2021-10-01Not available in this setting$2,868.10RVU21D
2021-07-01Not available in this setting$2,868.10RVU21C
2021-04-01Not available in this setting$2,868.10RVU21B
2021-01-01Not available in this setting$2,868.10RVU21A
2020-10-01Not available in this setting$2,659.91RVU20D
2020-07-01Not available in this setting$2,659.91RVU20C
2020-04-01Not available in this setting$2,659.91RVU20B
2020-01-01Not available in this setting$2,659.91RVU20A
2019-10-01Not available in this setting$2,649.82RVU19D
2019-07-01Not available in this setting$2,649.82RVU19C
2019-04-01Not available in this setting$2,649.82RVU19B
2019-01-01Not available in this setting$2,649.82RVU19A
2018-10-01Not available in this setting$2,623.78RVU18D
2018-07-01Not available in this setting$2,623.78RVU18C
2018-04-01Not available in this setting$2,623.78RVU18B
2018-01-01Not available in this setting$2,623.78RVU18AR1
2017-10-01Not available in this setting$2,638.61RVU17D
2017-07-01Not available in this setting$2,638.61RVU17C
2017-04-01Not available in this setting$2,638.61RVU17B
2017-01-01Not available in this setting$2,638.61RVU17A
2016-10-01Not available in this setting$2,628.86RVU16D
2016-07-01Not available in this setting$2,628.86RVU16C
2016-04-01Not available in this setting$2,628.86RVU16B
2016-01-01Not available in this setting$2,628.86RVU16A
2015-10-01Not available in this setting$2,647.28RVU15D
2015-07-01Not available in this setting$2,647.28RVU15C
2015-04-01Not available in this setting$2,634.11RVU15B
2015-01-01Not available in this setting$2,634.11RVU15A
2014-10-01Not available in this setting$2,654.60RVU14D
2014-07-01Not available in this setting$2,654.60RVU14C
2014-04-01Not available in this setting$2,654.60RVU14B
2014-01-01Not available in this setting$2,654.60RVU14A
2013-10-01Not available in this setting$2,612.60RVU13D
2013-07-01Not available in this setting$2,612.60RVU13C
2013-04-01Not available in this setting$2,612.60RVU13B
2013-01-01Not available in this setting$2,612.60RVU13AR

Price 59618 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

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
RVUs for 59618PPRRVU2026_Oct_nonQPP.csv, line 6,670 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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