CPT code 59618: Attempted VBAC, complete care, cesarean outcome2026 Medicare rate & RVUs in New York
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 doesn’t publish an office rate for 59618 in New York.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 9 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.
Where 59618 pays more and less in New York
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Manhattan, NY | Unavailable | $2,958.59 |
| NYC suburbs and Long Island, NY | Unavailable | $3,097.49 |
| Poughkeepsie and northern NYC suburbs, NY | Unavailable | $2,719.82 |
| Queens, NY | Unavailable | $2,907.64 |
| Rest of New York | Unavailable | $2,334.58 |
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.
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%).
59618 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 59610VBAC careComplete care through postpartum
- Use 59610 for the complete maternity-care package when the attempted vaginal birth after prior cesarean succeeds; 59618 applies when delivery is by cesarean.
- 59620VBAC deliveryAttempted, delivery only
- 59620 covers the cesarean delivery only after an attempted VBAC. Use 59618 when the practitioner provides the complete antepartum, delivery, and postpartum package.
- 59612VBAC deliveryDelivery only
- 59612 is for delivery only when the patient delivers vaginally after prior cesarean. It is not the complete-care code for an attempted VBAC ending in cesarean.
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
Fee sheets
Put 59618 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet