Reviewed by certified coders + a maternal-fetal medicine physician / Updated for 2026
OB Coding Guide
OB Coding Guide
obcodingguide.com/codes/59620/
Clinical review: Sina Haeri, MD, MHSA (MFM) · Coder review pending · Drafted July 2026
59620 Delivery
CPT 59620

CPT 59620: Cesarean After Attempted VBAC, Delivery OnlyCesarean After Attempted VBAC, Delivery Only

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 59620 when your practice performs a repeat cesarean after a trial of labor in a patient with a prior cesarean, but provides neither the antepartum package nor postpartum care. It is the component code for the in-labor transfer or the on-call conversion. With postpartum care, bill 59622; with the full pregnancy, the global code 59618 applies. Without any labor trial, the plain cesarean delivery-only code is 59514.

Source: CMSSource: ACOGSource: CMS MPFS 2026

When to use 59620

Report 59620 for the intrapartum event: managing the trial of labor and performing the cesarean when it converts. The most common scenario is a patient who arrives in labor, transferred or unassigned, attempts the VBAC under your management, and converts to surgery; her prenatal care and her postpartum care live elsewhere. As with all component codes, pair it with 59425 or 59426 if your practice also provided 4 or more antepartum visits, or individual E/M claims for 1 to 3. Both defining facts, the prior cesarean and the labor trial, need to be documented, or the payer will read the claim as a plain cesarean.

Documentation checklist

This claim asserts two clinical facts and one billing fact: a scarred uterus, a real labor trial, and a care span limited to the delivery. Document all three.

✓ Prior cesarean documented with the diagnosis on the claim
✓ Labor course recorded: onset or augmentation, progress, monitoring
✓ Stated indication for conversion to cesarean
✓ Operative note with date and technique
✓ Reason for component billing: in-labor transfer, coverage, or delivery-only referral
✓ Practice assuming postpartum care identified

Global package rules

59620 is the delivery component of 59618, for use when that global package has broken apart. The package boundaries are unchanged: separately billable services stay separately billable, and routine intrapartum management stays inside the delivery code. If postpartum care turns out to be yours, correct to 59622 rather than billing follow-up as E/M the payer will bundle. See The Global OB Package, explained. ACOG

Reimbursement

2026 · national Medicare averages
ComponentWork RVUTotal RVU2026 rate
59620Delivery only16.6625.52$852.39

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-16 Missing prior-cesarean or labor documentation
Why it happens
An attempted-VBAC code without the supporting history and labor record reads as inconsistent with the claim.
How to fix
Resubmit with the prior-cesarean diagnosis coded; on records request, supply the labor notes showing the attempt.
Source: CMS
CO-50 Downcoded to the plain cesarean 59514
Why it happens
The payer found no documented trial of labor and repriced the delivery.
How to fix
Appeal with timed labor documentation and the conversion indication. If the labor trial cannot be supported, accept the 59514 pricing.
Source: ACOG
CO-97 Component billed alongside a global code
Why it happens
The same practice submitted 59620 with 59618 for one pregnancy.
How to fix
Pick the structure that matches the care span and void the other line.
Source: NCCI
CO-119 Delivery already paid under another practice's global claim
Why it happens
The practice that provided prenatal care billed a global code across the transfer.
How to fix
Their claim corrects to antepartum-only codes; yours resubmits with the in-labor transfer documented.
Source: CMS
CO-54 Assistant surgeon denied
Why it happens
The assistant's line lacked modifier 80 or 82, or the payer restricts assistants on cesarean delivery.
How to fix
Resubmit with the correct assistant modifier and the operative note naming the assistant.
Source: CMS

FAQ

What is the CPT code description for 59620?
In plain language, 59620 covers a repeat cesarean performed after a trial of labor in a patient with a prior cesarean, the delivery event only, without antepartum or postpartum care.
Who ends up billing 59620?
Usually the practice or hospitalist that managed an in-labor patient whose prenatal care was elsewhere: she attempted the VBAC under your care, converted to surgery, and follows up with her own OB.
How is 59620 different from 59514?
Both are cesarean delivery-only codes. 59620 requires a prior cesarean and a documented trial of labor before the surgery; 59514 covers cesareans without that labor attempt.
Can I add antepartum codes to a 59620 claim?
Yes, when you provided them: 59425 for 4 to 6 documented visits or 59426 for 7 or more, alongside the delivery code. Fewer than 4 visits bill as individual E/M services.
What if I also see the patient for her postpartum visits?
Then the accurate code is 59622, which folds routine postpartum care into the delivery claim. Delivery-only plus separate postpartum E/M is the pattern payers bundle first.
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.