No office rate
59400 includes routine antepartum care and postpartum care along with vaginal delivery; 59409 is for the delivery service alone.
On this page
CMS RVU26D · Effective 2026-10-01
59409 Vaginal delivery Medicare reimbursement rates in Nevada
Vaginal delivery service, with or without episiotomy or forceps, reported when the clinician performs delivery but does not provide postpartum care. Compare 59409 office and facility rates across CMS payment localities in Nevada.
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 59409 in Nevada?
Nevada has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$699.48
1 of 1 localities have a supported rate.
Payment area: Nevada**
One mapped payment locality.
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 59409: Vaginal delivery without postpartum care
Vaginal delivery service, with or without episiotomy or forceps, reported when the clinician performs delivery but does not provide postpartum care.
This code represents the clinician’s work for a vaginal birth, whether spontaneous or assisted with forceps, and includes an episiotomy when performed. Obstetricians and other qualified clinicians report it for the delivery encounter, commonly in a hospital or other delivery setting; it is the delivery-only option rather than a package that also captures antepartum or postpartum care.
Select 59409 when the billed clinician’s service is the vaginal delivery and not the related antepartum/postpartum package. The record should support the vaginal birth and delivery services provided, including any forceps or episiotomy. Routine global surgery rules do not apply to this maternity code. If other procedures are performed in the same session, CMS pays the highest-valued procedure in full and reduces the others to 50% under the standard multiple-procedure rule.
CMS billing rules for 59409
- 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 RVU14.37 · 66%
- Practice expense (office) RVU3.22 · 15%
- Malpractice RVU4.02 · 19%
735
Medicare services in 2024 · #3219 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.
59409 compared with similar codes
Office rates for Nevada, from the same CMS release.
No office rate
59410 includes postpartum care after vaginal delivery. Choose 59409 when postpartum care is not part of the reported service.
No office rate
59514 is the delivery-only code for cesarean birth. 59409 is for vaginal delivery, including delivery with forceps when performed.
Compare 59409 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.
1 of 1 payment localities
Nevada** →
Office / nonfacility
Unavailable
Facility
$699.48
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 59409 in Nevada**.
PPRRVU2026_Oct_nonQPP.csv
6,656
- Code
- 59409
- Physician work
- 14.37
- Practice expense
- 3.22
- Malpractice
- 4.02
GPCI2026.csv
73
- Locality
- Nevada**
- Physician work
- 1.000
- Practice expense
- 1.001
- Malpractice
- 0.833
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.37 | × 1.000 | 14.3700 |
| Practice expense | 3.22 | × 1.001 | 3.2232 |
| Malpractice | 4.02 | × 0.833 | 3.3487 |
| Total RVUs | 20.9419 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nevada**$699.48
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14.37 | 1 |
| Practice expense | 3.22 | 1.001 |
| Malpractice | 4.02 | 0.833 |
(14.37 × 1 + 3.22 × 1.001 + 4.02 × 0.833) × $33.4009 = $699.48
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
59409 billing questions
When should 59409 be used instead of 59410?
Use 59409 for the vaginal delivery alone. 59410 covers the delivery and postpartum care.
How does 59409 differ from 59400?
59400 represents routine obstetric care that includes antepartum care, vaginal delivery, and postpartum care. Use 59409 when the reported service is the vaginal delivery only.
Are forceps or an episiotomy included?
Yes. The vaginal delivery service includes delivery with or without forceps and with or without episiotomy.
Does the usual surgical global period apply?
No. CMS identifies 59409 as a maternity code for which the usual global surgery rules do not apply.
How are other procedures performed in the same session paid?
Under CMS’s standard multiple-procedure rule, 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 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.
6,65359325,,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
6,65959414,,Deliver placenta,A,,1.61,0.35,NA,0.35,,0.50,2.46,2.46,0,MMM,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068
7612402,NJ,99,REST OF NEW JERSEY,1.040,1.092,1.097