Billing code 59510: Cesarean careMedicare rate & RVUs in Illinois
Report this package when the same physician or practice provides routine prenatal care, cesarean delivery, and postpartum care for a pregnancy.
CMS doesn’t publish an office rate for 59510 in Illinois.
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 59510 covers
This code represents routine obstetric care spanning prenatal visits, cesarean delivery, and postpartum care. An obstetrician-gynecologist or family physician providing obstetric services may report it when the physician or practice manages the pregnancy and performs the cesarean in a hospital, with prenatal and postpartum care furnished in office or other appropriate settings. It is not the choice when the reported service is limited to the delivery or to delivery plus postpartum care.
Report the package when documentation supports the antepartum, cesarean, and postpartum portions of care. If the services are divided among physicians or practices, select the applicable delivery-only or other component code rather than reporting the complete package. This maternity code follows the maternity-specific payment approach; the usual global surgery rules do not apply. When multiple procedures are performed in the same session, CMS pays the highest-valued procedure 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 59510 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $3,048.58 |
| East St. Louis | Unavailable | $2,860.19 |
| Rest Of Illinois | Unavailable | $2,659.68 |
| Suburban Chicago | Unavailable | $2,836.18 |
How the 59510 rate is calculated
Each of 59510’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 · 59510
RVUs × geographic indexes × conversion factor
Work41.05
41.05 RVUs× 1.000 GPCI
Practice expense20.00
20.00 RVUs× 1.000 GPCI
Malpractice13.00
13.00 RVUs× 1.000 GPCI
Adjusted RVUs
74.0500
Conversion factor
$33.4009
Medicare rate
$2,473.34
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 59510
The CMS indicators that decide how 59510 is paid alongside other services.
CMS payment indicators · 59510
Cesarean 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
59510 without 51 · national facility
$2,473.34
Cesarean care
59510-51 · Second procedure: 50%
$1,236.67
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%).
59510 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 59514Cesarean delivery
- Use 59514 for the cesarean delivery alone. It does not represent the routine antepartum and postpartum care included in 59510.
- 59515Cesarean delivery
- Use 59515 when cesarean delivery and postpartum care are furnished but antepartum care is not included in the reported package.
- 59525Cesarean hysterectomy
- 59525 reports a hysterectomy performed after cesarean delivery as an add-on; it is not a substitute for the obstetric care package.
- 59400Maternity care
- Both codes cover routine antepartum and postpartum care, but 59400 is for vaginal delivery rather than cesarean delivery.
59510 billing questions
When should 59510 be chosen over 59514?
Use 59510 when the practice provides routine antepartum care, performs the cesarean, and provides postpartum care. Use 59514 when reporting the cesarean delivery only.
Does 59510 include prenatal and postpartum care?
Yes. The package includes routine antepartum care, the cesarean delivery, and postpartum care; those services are not separately reported as parts of the same maternity package.
How does 59515 differ from 59510?
59515 covers cesarean delivery with postpartum care, but not the antepartum portion. Choose 59510 when the same physician or practice also furnished routine prenatal care.
What documentation supports reporting 59510?
The record should support the practice’s routine antepartum management, the cesarean delivery, and postpartum care. If one or more portions were furnished by another practice, use the applicable component-specific coding.
How are other procedures handled when performed with the cesarean?
For multiple procedures performed in the same session, CMS pays the highest-valued procedure in full and the other procedure or procedures at 50%. A hysterectomy after cesarean delivery may be reported with its separate add-on code when performed.
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
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