No office rate
Use 59610 for the complete maternity-care package when the attempted vaginal birth after prior cesarean succeeds; 59618 applies when delivery is by cesarean.
On this page
CMS RVU26D · Effective 2026-10-01
59618 Attempted VBAC Medicare reimbursement rates in California
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. Compare 59618 office and facility rates across CMS payment localities in California.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 59618 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$2380.85–$2740.30
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $359.45 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 59618 pays more and less in California
Obstetrics
About 59618: Maternity care with cesarean after VBAC attempt
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.
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%.
CMS billing rules for 59618
- Global period
- Maternity code: the usual global surgery rules do not apply.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Where the value comes from
- Work RVU41.57 · 56%
- Practice expense (office) RVU19.93 · 27%
- Malpractice RVU13.36 · 18%
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.
59618 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
59620 covers the cesarean delivery only after an attempted VBAC. Use 59618 when the practitioner provides the complete antepartum, delivery, and postpartum package.
No office rate
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.
Compare 59618 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office Unavailable | Facility $2416.20 |
| Chico | Office Unavailable | Facility $2380.85 |
| El Centro | Office Unavailable | Facility $2383.08 |
| Fresno | Office Unavailable | Facility $2380.85 |
| Hanford-Corcoran | Office Unavailable | Facility $2380.85 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $2529.20 |
| Madera | Office Unavailable | Facility $2380.85 |
| Merced | Office Unavailable | Facility $2380.85 |
| Modesto | Office Unavailable | Facility $2380.85 |
| Napa | Office Unavailable | Facility $2580.00 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $2492.19 |
| Redding | Office Unavailable | Facility $2380.85 |
| Rest Of California | Office Unavailable | Facility $2380.85 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $2523.69 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $2451.83 |
| Salinas | Office Unavailable | Facility $2442.22 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $2468.14 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $2663.81 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $2648.64 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $2740.30 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $2678.27 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $2409.47 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $2465.62 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $2442.72 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $2486.77 |
| Stockton | Office Unavailable | Facility $2380.85 |
| Vallejo | Office Unavailable | Facility $2558.14 |
| Visalia | Office Unavailable | Facility $2380.85 |
| Yuba City | Office Unavailable | Facility $2380.85 |
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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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
6,66759610,,Vbac delivery,A,,38.71,18.63,NA,18.63,,12.44,69.78,69.78,0,MMM,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,66859612,,Vbac delivery only,A,,16.09,3.41,NA,3.41,,5.15,24.65,24.65,0,MMM,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,66959614,,Vbac care after delivery,A,,20.48,4.88,NA,4.88,,6.57,31.93,31.93,0,MMM,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,67059618,,Attempted vbac delivery,A,,41.57,19.93,NA,19.93,,13.36,74.86,74.86,0,MMM,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,67159620,,Attempted vbac delivery only,A,,16.66,3.53,NA,3.53,,5.33,25.52,25.52,0,MMM,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,67259622,,Attempted vbac after care,A,,23.32,7.03,NA,7.03,,7.47,37.82,37.82,0,MMM,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,67359812,,Treatment of miscarriage,A,,4.33,5.06,,2.67,,1.37,10.76,8.37,0,090,0.17,0.60,0.23,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00