Billing code 59610: VBAC careMedicare rate & RVUs in Illinois
Report this code when a patient with a prior cesarean receives complete maternity care and delivers vaginally after attempting labor.
CMS doesn’t publish an office rate for 59610 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 59610 covers
This code represents complete maternity care for a patient with a previous cesarean who attempts labor and delivers vaginally. The package includes antepartum care, the vaginal delivery, and postpartum care. Obstetricians and other qualified maternity clinicians typically provide the care, with the delivery occurring in a hospital or birth center. The defining clinical distinction is a successful vaginal birth after cesarean, rather than a repeat cesarean delivery.
Select this code when the reporting clinician or group provides the complete course of care represented by the package. The record should support the prior cesarean, prenatal care, labor and vaginal delivery, and postpartum care. CMS classifies this as a maternity code, so the usual surgical global-period rules do not apply; the maternity services are described by the obstetric code itself. If multiple procedures are performed in the same session, CMS pays the highest-valued procedure in full and reduces the others to 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 59610 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 | $2,880.96 |
| East St. Louis | Unavailable | $2,702.26 |
| Rest Of Illinois | Unavailable | $2,510.51 |
| Suburban Chicago | Unavailable | $2,677.34 |
How the 59610 rate is calculated
Each of 59610’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 · 59610
RVUs × geographic indexes × conversion factor
Work38.71
38.71 RVUs× 1.000 GPCI
Practice expense18.63
18.63 RVUs× 1.000 GPCI
Malpractice12.44
12.44 RVUs× 1.000 GPCI
Adjusted RVUs
69.7800
Conversion factor
$33.4009
Medicare rate
$2,330.71
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 59610
The CMS indicators that decide how 59610 is paid alongside other services.
CMS payment indicators · 59610
VBAC 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) | 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
59610 without 51 · national facility
$2,330.71
VBAC care
59610-51 · Second procedure: 50%
$1,165.36
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%).
59610 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 59612VBAC delivery
- This code includes antepartum and postpartum care with the VBAC delivery. 59612 is limited to the delivery service.
- 59614VBAC delivery
- This code includes antepartum care as well as delivery and postpartum care. 59614 covers delivery with postpartum care, without the complete antepartum package.
- 59618Attempted VBAC
- Use this code for complete maternity care ending in vaginal delivery after a prior cesarean. 59618 describes an attempted VBAC that ends in cesarean delivery.
- 59400Maternity care
- Both represent complete maternity care ending in vaginal delivery, but this code is for a patient with a prior cesarean; 59400 is for routine obstetric care without that history.
59610 billing questions
When should this code be selected instead of a delivery-only code?
Use this code when the reported care includes antepartum care, vaginal delivery after a previous cesarean, and postpartum care. A delivery-only code is for circumstances in which the clinician reports only the delivery service.
Does this code include postpartum care?
Yes. The complete maternity package includes postpartum care along with antepartum care and the vaginal delivery.
What if the attempted VBAC ends in a cesarean delivery?
This code describes a vaginal birth after the prior cesarean. When the attempt results in cesarean delivery, consider the attempted-VBAC maternity code instead.
What documentation supports reporting this code?
Document the prior cesarean, the prenatal care provided, the labor attempt and vaginal delivery, and the postpartum care included in the reported package.
How does CMS apply multiple-procedure reduction?
When multiple procedures are performed in the same session, CMS pays the highest-valued procedure in full and reduces the other procedures to 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
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