No office rate
59409 reports vaginal delivery only. Choose 59400 when the same clinician or group also furnishes routine antepartum and postpartum care.
On this page
CMS RVU26D · Effective 2026-10-01
59400 Maternity care Medicare reimbursement rates in Massachusetts
Report this maternity package when one clinician or group provides routine prenatal care, vaginal delivery, and routine postpartum care for the pregnancy. Compare 59400 office and facility rates across CMS payment localities in Massachusetts.
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 59400 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$2196.00–$2347.98
2 of 2 localities have a supported rate.
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.
Obstetrics
About 59400: Complete routine vaginal maternity care
Report this maternity package when one clinician or group provides routine prenatal care, vaginal delivery, and routine postpartum care for the pregnancy.
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.
CMS billing rules for 59400
- 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 RVU37.00 · 56%
- Practice expense (office) RVU18.76 · 28%
- Malpractice RVU10.54 · 16%
1.2K
Medicare services in 2024 · #2861 by national volume
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 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
No office rate
59410 includes vaginal delivery and postpartum care but not the antepartum package. Use 59400 when all three care components are furnished.
$576.59–$623.84
59425 covers antepartum care only within its visit range. It does not represent the vaginal delivery and postpartum care included in 59400.
No office rate
59510 represents a complete maternity package with cesarean delivery. 59400 is the complete package for vaginal delivery.
Compare 59400 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.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
Unavailable
Facility
$2347.98
Rest Of Massachusetts →
Office / nonfacility
Unavailable
Facility
$2196.00
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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 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.
6,65259320,,Revision of cervix,A,,2.42,0.90,NA,0.90,,0.79,4.11,4.11,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,65359325,,Revision of cervix,A,,3.96,1.22,NA,1.22,,1.27,6.45,6.45,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,65459350,,Repair of uterus,A,,4.82,1.02,NA,1.02,,1.53,7.37,7.37,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,65559400,,Obstetrical care,A,,37.00,18.76,NA,18.76,,10.54,66.30,66.30,0,MMM,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,65659409,,Obstetrical care,A,,14.37,3.22,NA,3.22,,4.02,21.61,21.61,0,MMM,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,65759410,,Obstetrical care,A,,18.76,5.13,NA,5.13,,5.34,29.23,29.23,0,MMM,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,65859412,,Antepartum manipulation,A,,1.71,0.57,NA,0.57,,0.54,2.82,2.82,0,MMM,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00