On this page

CMS RVU26D · Effective 2026-10-01

59612 VBAC delivery Medicare reimbursement rates in New Jersey

Reports the delivery service when a patient with a prior cesarean gives birth vaginally and the clinician provides delivery care only. Compare 59612 office and facility rates across CMS payment localities in New Jersey.

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 59612 in New Jersey?

New Jersey 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

$871.99–$887.11

2 of 2 localities have a supported rate.

Lowest: Rest Of New Jersey

Highest: Northern Nj

A spread of $15.12 per service.

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.

Find 59612 in your payment locality →

Obstetrics

About 59612: Vaginal delivery after prior cesarean

Reports the delivery service when a patient with a prior cesarean gives birth vaginally and the clinician provides delivery care only.

This code represents the clinician’s delivery service when a patient with a prior cesarean gives birth vaginally, with or without episiotomy or forceps. It covers the delivery portion alone, rather than the complete obstetric package. An obstetrician or family physician commonly reports it for a hospital birth after labor following cesarean ends in vaginal delivery.

Report 59612 when the billing clinician furnishes the vaginal delivery but not the antepartum and postpartum care represented by the comprehensive maternity code. Documentation should establish the prior cesarean, vaginal delivery, and which obstetric-care components the clinician provided. Do not use it when the trial of labor ends in cesarean delivery. CMS treats this as a maternity code, so usual global surgery rules do not apply. If another procedure subject to the standard multiple-procedure rule is performed in the same session, the highest-valued procedure is paid in full and the others at 50%.

CMS billing rules for 59612

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 RVU16.09 · 65%
  • Practice expense (office) RVU3.41 · 14%
  • Malpractice RVU5.15 · 21%

42

Medicare services in 2024 · #5471 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.

59612 compared with similar codes

Office rates for New Jersey, from the same CMS release.

59610

VBAC care

Complete care through postpartum

No office rate

59610 includes routine antepartum and postpartum care along with vaginal delivery after a prior cesarean. 59612 is limited to the delivery service.

59409

Vaginal delivery

Delivery only

No office rate

59409 is the delivery-only vaginal birth code when the prior-cesarean circumstance is not present. 59612 is specific to vaginal delivery after a prior cesarean.

59620

VBAC delivery

Attempted, delivery only

No office rate

59620 is for cesarean delivery only after attempted vaginal delivery following a prior cesarean. 59612 applies when that delivery is vaginal.

59618

Attempted VBAC

Complete care, cesarean outcome

No office rate

59618 covers routine obstetric care through attempted vaginal delivery and cesarean after a prior cesarean. 59612 covers delivery only when the birth is vaginal.

Compare 59612 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

Office and facility base rates · shared scale starting at $0

Need rates for a whole code list?

Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.

Explore fee-sheet early access →

59612 billing questions

How does 59612 differ from 59610?

59612 reports the vaginal delivery only. Use 59610 when the clinician provides the comprehensive obstetric care package, including antepartum care, delivery, and postpartum care.

Does 59612 include antepartum or postpartum care?

No. It represents the vaginal delivery service only; report the appropriate maternity-care code when the clinician also provides other obstetric-care components.

What if labor after the prior cesarean ends in cesarean delivery?

Use the code matching the care furnished and delivery outcome. 59620 represents cesarean delivery only after attempted vaginal delivery following a prior cesarean; 59618 includes routine care through that attempted delivery and cesarean.

What should the record support?

The record should show the prior cesarean, the successful vaginal delivery, and that the billed clinician furnished the delivery service rather than the full antepartum and postpartum package.

Does the usual surgical global period apply?

No. CMS identifies 59612 as a maternity code, for which the usual global surgery rules do not apply.

How is it paid when 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 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.

RVUs for 59612PPRRVU2026_Oct_nonQPP.csv, line 6,668 (RVU26D)