CPT 59618: Repeat Cesarean Delivery After Failed Trial of Labor
Medicare pays $2506 and commercial payers pay $3194 on average nationally for this procedure.
CPT code 59618 describes a global obstetric service covering comprehensive antepartum care, hospital admission for delivery, intensive intrapartum management culminating in repeat cesarean delivery via abdominal incision after a failed trial of labor after prior cesarean, and routine inpatient and outpatient postpartum follow-up; service type: global obstetric surgical care, typical site of service: outpatient prenatal clinics and inpatient hospital (labor and 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.
Customize your policy alerts
Sign up for cpt 59618 policy alerts
Get alerted when payer policies referencing 59618 are released or updated.
Monitor payer policy activity
National Reimbursement Benchmarks
Medicare's mean allowed amount for CPT 59618 sits at $2,506, which is meaningfully below BUCA's average commercial mean of $3,193.80. That $687.80 gap highlights that commercial arrangements captured by BUCA are, on average, substantially higher than Medicare levels for this code, with Medicare concentrated around a narrower central tendency (P25 $2,393, P50 $2,459, P75 $2,618) compared with BUCA's broader commercial spread (P25 $2,077.80, P50 $2,951.70, P75 $3,949.30). These differences underscore a notable gulf between public program pricing and commercial reimbursement norms.
Dispersion measured as P75 minus P25 varies across payers: Blue Cross Blue Shield shows a tight interquartile range of $1,386.90, while Aetna's IQR is $2,053.00 and Cigna's is $2,637.80. UnitedHealth Group and BUCA exhibit the widest spreads at $2,331.20 and $1,871.50 respectively. In this context, Blue Cross Blue Shield appears most compressed around its central values; Cigna and UnitedHealth Group demonstrate the greatest price variability within the middle 50% of their distributions.