Billing code 59400: Maternity careMedicare rate & RVUs in Guam
Report this maternity package when one clinician or group provides routine prenatal care, vaginal delivery, and routine postpartum care for the pregnancy.
CMS doesn’t publish an office rate for 59400 in Guam.
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 59400 covers
This package represents routine care across pregnancy, vaginal birth, and the postpartum period. It includes prenatal management and a vaginal delivery, with or without episiotomy or forceps, followed by routine postpartum care. It is typically furnished by an obstetrician or another qualified maternity-care clinician in an office and hospital setting. The delivery component is for vaginal birth, not cesarean delivery.
Report 59400 when the same clinician or group furnishes all three components. The record should support the antepartum care, delivery, and postpartum services provided; when care is divided, report the applicable components rather than the complete package. CMS treats this as a maternity code, so the usual global surgery rules do not apply. If qualifying procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50% under the standard multiple procedure reduction.
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.
59400 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $2,152.11 |
How the 59400 rate is calculated
Each of 59400’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 · 59400
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 37.00Practice expense 18.76Malpractice 10.54
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 59400
The CMS indicators that decide how 59400 is paid alongside other services.
CMS payment indicators · 59400
Maternity care
| 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) | 1 | Not paid (statutory restriction). |
| 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
59400 without 51 · national facility
$2,214.48
Maternity care
59400-51 · Second procedure: 50%
$1,107.24
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%).
59400 compared with similar codes
Compare codes
59400 vs 59409 vs 59410 vs 59425 vs 59510: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 59409Vaginal delivery
- 59409 reports vaginal delivery only. Choose 59400 when the same clinician or group also furnishes routine antepartum and postpartum care.
- 59410Vaginal delivery
- 59410 includes vaginal delivery and postpartum care but not the antepartum package. Use 59400 when all three care components are furnished.
- 59425Prenatal care
- 59425 covers antepartum care only within its visit range. It does not represent the vaginal delivery and postpartum care included in 59400.
- 59510Cesarean care
- 59510 represents a complete maternity package with cesarean delivery. 59400 is the complete package for vaginal delivery.
59400 billing questions
When should 59400 be used instead of 59409?
Use 59400 when the clinician or group provides routine antepartum care, vaginal delivery, and postpartum care. Code 59409 is for the vaginal delivery component only.
Can 59400 be reported if another clinician provided postpartum care?
No. The complete package represents all three components; when care is divided, report the applicable services furnished by each clinician or group.
Does 59400 include forceps or episiotomy during vaginal delivery?
The vaginal delivery component includes delivery with or without forceps or episiotomy. The package also includes routine antepartum and postpartum care.
How does CMS apply the global surgery rules to 59400?
59400 is a maternity code, and the usual global surgery rules do not apply. Its package is defined by the obstetric care furnished across pregnancy, delivery, and postpartum care.
What happens if 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 qualifying 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 59400 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 →