CPT code 59612: VBAC delivery2026 Medicare rate & RVUs in Georgia
Reports the delivery service when a patient with a prior cesarean gives birth vaginally and the clinician provides delivery care only.
CMS doesn’t publish an office rate for 59612 in Georgia.
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 9 sections
What 59612 covers
This code represents the clinician’s delivery service when a patient with a prior cesarean gives birth vaginally, with or without episiotomy or forceps. It covers the delivery portion alone, rather than the complete obstetric package. An obstetrician or family physician commonly reports it for a hospital birth after labor following cesarean ends in vaginal delivery.
Report 59612 when the billing clinician furnishes the vaginal delivery but not the antepartum and postpartum care represented by the comprehensive maternity code. Documentation should establish the prior cesarean, vaginal delivery, and which obstetric-care components the clinician provided. Do not use it when the trial of labor ends in cesarean delivery. CMS treats this as a maternity code, so usual global surgery rules do not apply. If another procedure subject to the standard multiple-procedure rule is performed in the same session, the highest-valued procedure is paid in full and the others 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 59612 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | Unavailable | $861.34 |
| Rest Of Georgia | Unavailable | $844.06 |
How the 59612 rate is calculated
Each of 59612’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 · 59612
RVUs × geographic indexes × conversion factor
Work16.09
16.09 RVUs× 1.000 GPCI
Practice expense3.41
3.41 RVUs× 1.000 GPCI
Malpractice5.15
5.15 RVUs× 1.000 GPCI
Adjusted RVUs
24.6500
Conversion factor
$33.4009
Medicare rate
$823.33
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 59612
The CMS indicators that decide how 59612 is paid alongside other services.
CMS payment indicators · 59612
VBAC delivery
| 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
59612 without 51 · national facility
$823.33
VBAC delivery
59612-51 · Second procedure: 50%
$411.67
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%).
59612 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 59610VBAC care
- 59610 includes routine antepartum and postpartum care along with vaginal delivery after a prior cesarean. 59612 is limited to the delivery service.
- 59409Vaginal delivery
- 59409 is the delivery-only vaginal birth code when the prior-cesarean circumstance is not present. 59612 is specific to vaginal delivery after a prior cesarean.
- 59620VBAC delivery
- 59620 is for cesarean delivery only after attempted vaginal delivery following a prior cesarean. 59612 applies when that delivery is vaginal.
- 59618Attempted VBAC
- 59618 covers routine obstetric care through attempted vaginal delivery and cesarean after a prior cesarean. 59612 covers delivery only when the birth is vaginal.
59612 billing questions
How does 59612 differ from 59610?
59612 reports the vaginal delivery only. Use 59610 when the clinician provides the comprehensive obstetric care package, including antepartum care, delivery, and postpartum care.
Does 59612 include antepartum or postpartum care?
No. It represents the vaginal delivery service only; report the appropriate maternity-care code when the clinician also provides other obstetric-care components.
What if labor after the prior cesarean ends in cesarean delivery?
Use the code matching the care furnished and delivery outcome. 59620 represents cesarean delivery only after attempted vaginal delivery following a prior cesarean; 59618 includes routine care through that attempted delivery and cesarean.
What should the record support?
The record should show the prior cesarean, the successful vaginal delivery, and that the billed clinician furnished the delivery service rather than the full antepartum and postpartum package.
Does the usual surgical global period apply?
No. CMS identifies 59612 as a maternity code, for which the usual global surgery rules do not apply.
How is it paid when 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 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
Fee sheets
Put 59612 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →