CPT 59400: Routine Obstetric Care with Vaginal Delivery, Global
Medicare pays $2227 and commercial payers pay $3057 on average nationally for this procedure.
CPT code 59400 describes a global obstetric service that includes comprehensive antepartum care beginning in early pregnancy, hospital admission for delivery, labor management (including induction and fetal monitoring), vaginal delivery of the fetus and placenta (including use of low forceps and episiotomy when performed), and routine inpatient and outpatient postpartum care for approximately six weeks; this service type is routine obstetric care with global delivery and the typical site of service is outpatient prenatal clinics and inpatient hospital delivery and postpartum settings.
For related coverage guidance, see recent payer policy updates: Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders.
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National Reimbursement Benchmarks
Commercial averages sit well above Medicare for CPT 59400: BUCA’s mean of $3,057.20 is about $829.80 higher than Medicare’s mean of $2,227.40, reflecting a meaningful spread between an average commercial network and the federal benchmark. Blue Cross Blue Shield, Cigna, Aetna and UnitedHealth Group also present higher means than Medicare, reinforcing that commercial reimbursements generally exceed the Medicare baseline.
Dispersion varies by payer. Calculate P75–P25 ranges: Aetna $2,220.00, Blue Cross Blue Shield $1,178.70, BUCA $1,679.90, Cigna $2,311.00, UnitedHealth Group $2,011.20, Medicare $170.00. Blue Cross Blue Shield is the tightest among these payers while Cigna and Aetna show the widest interquartile spreads, indicating larger variability in mid-to-upper commercial reimbursement levels.