Billing code 59620: VBAC deliveryMedicare rate & RVUs in Virginia

Reports the delivery-only service for a trial of labor after a prior cesarean when the attempt does not result in vaginal birth.

CMS RVU26DEffective Oct 1, 20262 payment localities

CMS doesn’t publish an office rate for 59620 in Virginia.

—Office (non-facility)
$798.05–$923.54Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 59620 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Virginia
  2. What 59620 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 59620 covers

This code covers the delivery service when a patient with a prior cesarean undergoes a trial of labor intended to achieve vaginal birth, but the attempt ends without a vaginal delivery. It is generally used by the obstetrician or other qualified clinician managing the labor and delivery when a cesarean delivery follows the attempted VBAC. The service is limited to the delivery portion of care, rather than a complete maternity-care package.

Report it when documentation supports the prior cesarean, the attempted trial of labor, and the delivery outcome. Antepartum and postpartum care are outside this delivery-only service and may be reported separately when appropriate. This maternity code is not subject to the usual global surgery rules. If procedures subject to the standard multiple-procedure reduction are performed in the same session, the highest-valued procedure is paid in full and the others at 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 59620 pays more and less in Virginia

59620 office and facility rates by payment locality
Payment localityOfficeFacility
Dc + Md/Va SuburbsUnavailable$923.54
VirginiaUnavailable$798.05

How the 59620 rate is calculated

Each of 59620’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 · 59620

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 16.66Practice expense 3.53Malpractice 5.33

25.5200 adjusted RVUs×$33.4009 conversion factor=$852.39

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 59620

The CMS indicators that decide how 59620 is paid alongside other services.

CMS payment indicators · 59620

VBAC delivery

RuleCMS valueWhat it means
Global periodMMMMaternity care: global rules don’t follow the standard pattern.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

59620 without 51 · national facility

$852.39

VBAC delivery

59620-51 · Second procedure: 50%

$426.20

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%).

When to use modifier 51

59620 compared with similar codes

Compare codes

59620 vs 59612 vs 59618 vs 59622: national Medicare rates

Swap in your local Medicare rate.

  • 59620
    VBAC delivery · 16.66 wRVU
    —
  • 59612
    VBAC delivery · 16.09 wRVU
    —
  • 59618
    Attempted VBAC · 41.57 wRVU
    —
  • 59622
    Postpartum care · 23.32 wRVU
    —

How to choose

59612VBAC delivery
Choose 59612 for delivery-only care when the patient achieves vaginal birth after a prior cesarean. Choose 59620 when the attempted VBAC does not result in vaginal birth.
59618Attempted VBAC
59618 includes antepartum and postpartum care with the attempted VBAC service. 59620 is limited to the delivery portion.
59622Postpartum care
59622 represents postpartum care only after attempted VBAC care; 59620 represents the attempted VBAC delivery service.

59620 billing questions

When should 59620 be chosen instead of 59612?

Use 59620 when the attempted trial of labor after a prior cesarean does not result in vaginal birth. Code 59612 describes a successful VBAC delivery only.

Does 59620 include antepartum and postpartum care?

No. It covers the delivery portion only; antepartum care and postpartum care are not included in this delivery-only service.

What documentation supports reporting 59620?

Document the prior cesarean, the trial of labor intended to achieve vaginal birth, and the delivery outcome showing that vaginal birth was not achieved.

How does 59620 differ from 59618?

59620 is for the attempted VBAC delivery service only. 59618 describes the broader maternity-care package, including antepartum and postpartum care.

How does the multiple-procedure rule affect 59620?

When procedures subject to the standard multiple-procedure reduction occur in the same session, the highest-valued procedure is paid in full and the others 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
RVUs for 59620PPRRVU2026_Oct_nonQPP.csv, line 6,671 (RVU26D)

Open CMS sourceHow we calculate rates

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