Billing code 59409: Vaginal deliveryMedicare rate & RVUs in Ohio
Vaginal delivery service, with or without episiotomy or forceps, reported when the clinician performs delivery but does not provide postpartum care.
CMS doesn’t publish an office rate for 59409 in Ohio.
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 59409 covers
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.
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 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $713.51 |
How the 59409 rate is calculated
Each of 59409’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 · 59409
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 14.37Practice expense 3.22Malpractice 4.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 59409
The CMS indicators that decide how 59409 is paid alongside other services.
CMS payment indicators · 59409
Vaginal delivery
| 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
59409 without 51 · national facility
$721.79
Vaginal delivery
59409-51 · Second procedure: 50%
$360.90
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%).
59409 compared with similar codes
Compare codes
59409 vs 59400 vs 59410 vs 59514: national Medicare rates
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How to choose
- 59400Maternity care
- 59400 includes routine antepartum care and postpartum care along with vaginal delivery; 59409 is for the delivery service alone.
- 59410Vaginal delivery
- 59410 includes postpartum care after vaginal delivery. Choose 59409 when postpartum care is not part of the reported service.
- 59514Cesarean delivery
- 59514 is the delivery-only code for cesarean birth. 59409 is for vaginal delivery, including delivery with forceps when performed.
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 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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