Reviewed by certified coders + a maternal-fetal medicine physician / Updated for 2026
OB Coding Guide
OB Coding Guide
obcodingguide.com/codes/59400/
Clinical review: Sina Haeri, MD, MHSA (MFM) · Coder review pending · Drafted July 2026
59400 Delivery
CPT 59400

CPT 59400: Global OB Care, Vaginal DeliveryGlobal OB Care, Vaginal Delivery

2027 change This code is scheduled for deletion on January 1, 2027, when CPT unbundles the global maternity package. Current rules apply through 2026 dates of service. See what replaces it →
The short answer

Use 59400 to bill routine maternity care as one bundle: antepartum visits, vaginal delivery, and postpartum care by one practice. Bill it after delivery, not visit by visit. If your practice does not perform the delivery, use antepartum-only codes 59425 or 59426 instead. For cesarean delivery the global code is 59510.

Source: CMSSource: ACOGSource: CMS MPFS 2026

When to use 59400

Report 59400 when a single practice provides the full arc of routine pregnancy care: the antepartum visit schedule (roughly 13 visits for a term pregnancy), the vaginal delivery with any episiotomy or forceps assistance, and routine postpartum care. The code is submitted once, after delivery, with the delivery date as the date of service for most payers. It is the highest-value single code most OB practices bill, which is exactly why payers audit what gets billed alongside it.

When to use 59400 vs the component codes
59400 · Global package
  • One practice provides antepartum, delivery, and postpartum
  • Routine care without a mid-pregnancy transfer
  • Vaginal delivery (cesarean uses 59510, VBAC uses 59610)
  • Billed once, after delivery
Component codes
  • Care transferred in or out mid-pregnancy
  • Antepartum only: 59425 (4–6 visits) or 59426 (7+)
  • Delivery only: 59409, or 59410 with postpartum
  • Fewer than 4 antepartum visits: bill E/M per visit

Documentation checklist

The global fee is defended by showing the full span of care actually happened in your practice, and that anything billed separately was genuinely outside routine care.

✓ Antepartum flow sheet with visit dates and count
✓ Delivery note with date, route, and any assistance used
✓ Postpartum visit documented within the payer's global window
✓ Separately billed services tied to distinct diagnoses, not routine care
✓ Transfer-of-care date documented when the patient arrived mid-pregnancy
✓ High-risk problem visits documented as separate E/M with their own indication
✓ Payer-specific global period confirmed (most follow the CPT package definition)

Global package rules

59400 is the global package. What matters is what stays outside it: obstetric ultrasounds (76805, 76811), fetal non-stress tests (59025), lab work, and management of complications beyond routine care are all separately billable. Problem visits for conditions like hypertension or gestational diabetes can be reported as distinct E/M services with the appropriate diagnosis. See the full breakdown in The Global OB Package, explained. ACOG

Reimbursement

2026 · national Medicare averages
ComponentWork RVUTotal RVU2026 rate
59400Global package37.0066.30$2,214.48

National amounts under the 2026 Medicare Physician Fee Schedule (non-facility total RVU x $33.4009 conversion factor, no locality/MAC adjustment). Commercial and Medicaid rates differ. Verify current values with your MAC before billing.

Common denials

CO-97 E/M visit bundled into the global fee
Why it happens
The payer treated a separately billed antepartum E/M visit as part of routine global care.
How to fix
Confirm the visit addressed a distinct problem with its own diagnosis code, append modifier 25 where a same-day service applies, and appeal with the documentation showing care beyond routine antepartum visits.
Source: NCCI
CO-16 Missing delivery date or provider details
Why it happens
Global claims need the delivery date as date of service and a consistent billing provider; claims missing either reject as unprocessable.
How to fix
Resubmit with the delivery date, the correct rendering NPI, and one billing entity for the full package.
Source: CMS
CO-236 59400 billed with antepartum codes
Why it happens
The claim included 59425 or 59426 alongside the global code for the same pregnancy.
How to fix
Bill either the global package or the antepartum-only codes, never both. Pick the component codes only when the practice did not perform the delivery.
Source: NCCI
CO-50 Visit count below payer threshold
Why it happens
The patient transferred in late and the practice provided too few antepartum visits to support the full global fee.
How to fix
Bill the components: E/M codes for 1–3 visits, 59425 for 4–6, 59426 for 7 or more, plus the delivery-only code.
Source: ACOG
CO-119 Global fee already paid to another practice
Why it happens
Two practices both billed global codes for the same pregnancy after a mid-pregnancy transfer.
How to fix
Coordinate the split: the delivering practice bills delivery and postpartum components, the transferring practice bills antepartum-only codes for its visit count.
Source: CMS

FAQ

What is the CPT code description for 59400?
In plain language, 59400 covers complete routine obstetric care with a vaginal delivery: the antepartum visits, the delivery itself including any episiotomy or forceps assistance, and routine postpartum care, billed as a single package by one practice.
When do I bill 59400, at the first visit or after delivery?
After delivery. The global package is billed once the full episode of care is complete, with the delivery date as the date of service for most payers.
What if the patient transfers out before delivery?
You forfeit the global fee. Bill antepartum-only codes based on visit count: 59425 for 4 to 6 visits, 59426 for 7 or more, or individual E/M codes for fewer than 4.
Are ultrasounds included in 59400?
No. Obstetric ultrasounds bill separately from the global package, as do non-stress tests, labs, and management of complications beyond routine care.
How do twins change 59400 billing?
Bill the global package for the first delivery, then the delivery-only code for the second twin, with exact modifier requirements varying by payer. Check the payer's multiple-gestation policy.
CPT® is a registered trademark of the American Medical Association. Educational reference only, not billing, legal, or medical advice. Maintained by Ouma Health, a maternal-fetal telemedicine practice. Printed from obcodingguide.com, content current as of July 2026.