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OB/GYN Billing Services

OB/GYN billing combines the complexity of obstetric global packages with high-volume gynecologic office visits and surgical procedures. The global maternity package alone requires understanding antepartum, delivery, and postpartum coding rules that most general billers get wrong.

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59400OB Global
59510C-Section
58558Hysteroscopy
76801OB Ultrasound

Why OB/GYN Billing Requires Specialty Expertise

Obstetric billing uses global maternity codes (59400 vaginal, 59510 cesarean, 59610 VBAC) that bundle antepartum visits, delivery, and postpartum care. But high-risk antepartum visits, complications, and procedures outside the global package can be billed separately with the right documentation. Gynecologic billing covers office procedures (colposcopy, endometrial biopsy), surgery (hysterectomy, laparoscopy), and preventive care.

Common OB/GYN CPT Codes

Our coders handle these ob/gyn codes daily. This is not an exhaustive list.

Code
Description
59400
Routine obstetric care (vaginal delivery, global)
59510
Cesarean delivery (global)
59610
VBAC (vaginal birth after cesarean, global)
59025
Fetal non-stress test
57454
Colposcopy with biopsy
58558
Hysteroscopy with biopsy
58571
Laparoscopic hysterectomy
76801
OB ultrasound, first trimester

2026 Medicare Allowables for OB/GYN CPT Codes by State

Medicare reimbursement for ob/gynprocedures is not a single national number. Each code's allowable is adjusted by your state's Geographic Practice Cost Index (GPCI) and processed under that state's Medicare Administrative Contractor (MAC), so the same ob/gyn CPT code pays a different amount in California than it does in Texas or Florida. The table below shows the 8 core ob/gyncodes our coders bill priced at each state's 2026 locality. The non-facility figure is what an office-based practice collects. The facility figure applies when the service is performed in a hospital-based setting.

Commercial carriers in each state typically reimburse above these Medicare benchmarks and state Medicaid below them, but the Medicare allowable is the contracting anchor every payer negotiation starts from. Compare any individual code across all states with our Medicare fee calculator by state.

2026 Medicare non-facility allowable for OB/GYN CPT codes across high-volume states
CodeOB/GYN ProcedureCATXFLNYPAILOHGANCMI
59400Routine obstetric care (vaginal delivery, global)$2,212.48$2,186.53$2,549.84$2,472.09$2,237.05$2,518.37$2,162.78$2,256.68$2,045.41$2,319.72
59510Cesarean delivery (global)$2,446.17$2,439.64$2,886.62$2,771.69$2,501.94$2,851.16$2,418.69$2,529.98$2,271.83$2,609.53
59610VBAC (vaginal birth after cesarean, global)$2,300.92$2,298.63$2,726.14$2,613.35$2,358.27$2,692.77$2,279.90$2,385.68$2,139.03$2,462.07
59025Fetal non-stress test$54.12$49.76$54.96$56.22$50.33$53.80$48.00$50.08$46.85$50.61
57454Colposcopy with biopsy$176.68$164.28$178.91$183.28$166.03$175.84$159.43$165.20$156.03$166.76
58558Hysteroscopy with biopsy$1,467.19$1,251.73$1,296.37$1,413.30$1,250.03$1,254.83$1,173.53$1,223.78$1,186.86$1,211.99
58571Laparoscopic hysterectomy$844.92$820.58$923.39$915.35$834.98$912.63$808.52$837.82$776.73$854.41
76801OB ultrasound, first trimester$132.27$115.66$119.07$128.70$115.65$116.06$109.74$113.55$110.65$112.69

Full OB/GYN fee detail by state

2026 Medicare allowables for ob/gyn CPT codes in California, processed under Noridian Healthcare Solutions (Jurisdiction E). See California medical billing.

2026 Medicare allowables for OB/GYN CPT codes in California
CodeDescriptionNon-FacilityFacility
59400Routine obstetric care (vaginal delivery, global)$2,212.48$2,212.48
59510Cesarean delivery (global)$2,446.17$2,446.17
59610VBAC (vaginal birth after cesarean, global)$2,300.92$2,300.92
59025Fetal non-stress test$54.12$54.12
57454Colposcopy with biopsy$176.68$120.96
58558Hysteroscopy with biopsy$1,467.19$206.42
58571Laparoscopic hysterectomy$844.92$844.92
76801OB ultrasound, first trimester$132.27$132.27

Source: 2026 Medicare Physician Fee Schedule, locality-adjusted by state MAC. Figures are for reference and contracting benchmarks, not a guarantee of payment.

OB/GYN Billing Challenges We Solve

Common billing problems in ob/gyn and how our team handles them.

Global Package Complexity

The OB global includes 13 antepartum visits, delivery, and postpartum. Unbundling errors in either direction cause denials.

High-Risk Add-Ons

High-risk conditions (gestational diabetes, preeclampsia) justify additional visits outside the global. Must be coded separately.

Same-Day OB + GYN

When an OB patient has a GYN problem at the same visit, both can be billed with proper documentation and modifier usage.

Surgical Gynecology

Hysterectomy, laparoscopy, and hysteroscopy have multiple approach codes. Wrong selection means wrong reimbursement.

Common OB/GYN Denial Reasons

We prevent these before submission and appeal aggressively when they occur.

!
Antepartum visit billed outside global without documentation
!
High-risk condition not coded as secondary diagnosis
!
Ultrasound medical necessity not established
!
Colposcopy billed without qualifying Pap result
!
Hysterectomy approach code mismatch
!
Global package split billing errors on transfers

Revenue Opportunities Most OB/GYN Practices Miss

OB/GYN practices miss revenue primarily in three areas. First, unbundling high-risk antepartum care from the global package. When a pregnant patient develops gestational diabetes, preeclampsia, or another complication, the additional monitoring visits, non-stress tests, and ultrasounds beyond the standard prenatal schedule are separately billable — but only if coded correctly with the complication diagnosis as primary. Many practices include these in the global package, losing $200 to $500 per additional visit. Second, same-day OB + GYN coding. When a patient presents for a routine prenatal visit but also has a GYN concern (abnormal bleeding, pelvic pain, breast lump), the GYN evaluation is separately billable from the antepartum global with modifier 25. This adds $80 to $150 per encounter and occurs more frequently than practices realize. Third, postpartum visit coding. The postpartum visit is included in the global package, but complications discovered at the postpartum visit (wound complications, postpartum depression requiring treatment, new GYN conditions) can be billed separately. Additionally, contraceptive counseling (99401-99404) and IUD/implant insertion performed at the postpartum visit are separately billable from the global.

Payer-Specific OB/GYN Billing Tips

Obstetric billing follows a global package model where one payment covers antepartum, delivery, and postpartum care. Medicare rarely applies (most OB patients are under 65), but Medicaid is a major OB payer. Medicaid OB billing rules vary significantly by state — some states use global packages, others pay per-visit, and managed Medicaid plans may have their own policies. Commercial payers generally follow the global package model but differ on when to submit the global claim. Most require submission after delivery with the delivery date as the date of service. Some allow monthly antepartum billing during pregnancy. We track each payer's preferred submission timing. For gynecologic surgery, prior authorization requirements vary by procedure and payer. Hysterectomy (all approaches) requires auth from virtually all commercial payers. Laparoscopic procedures, hysteroscopy, and endometrial ablation have variable auth requirements. Payers increasingly require documentation of conservative treatment failure before approving surgical intervention — we include this history in the auth request.

OB/GYN Billing Best Practices

Practical tips from our coding team to maximize reimbursement and minimize denials.

1
Track all 13 antepartum visits within the OB global package. Visits beyond the standard 13 can be billed separately with modifier 22 documentation or as complication-related E/M visits.
2
When a patient transfers care mid-pregnancy, split the global package using antepartum-only (59425/59426), delivery-only (59409/59514), and postpartum-only (59430) codes.
3
High-risk conditions (gestational diabetes, preeclampsia, multiple gestation) justify additional visits billed separately from the global with condition-specific ICD-10 codes.
4
For gynecologic surgery, the surgical approach (vaginal, abdominal, laparoscopic, robotic) determines the CPT code. Robotic-assisted procedures use laparoscopic codes with modifier 22 when appropriate.
5
Colposcopy (57452-57461) coding depends on whether biopsies were taken and the number of sites. Document each biopsy site separately.

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What We Handle for OB/GYN Practices

Obstetric global package management
High-risk pregnancy coding and billing
Gynecologic office procedure coding
Surgical gynecology (hysterectomy, laparoscopy)
OB ultrasound and fetal testing billing
Colposcopy and cervical biopsy coding
Preventive GYN visit optimization
Prior auth for GYN surgery and imaging

Why Choose Go Medical Billing for OB/GYN

OB/GYN billing requires understanding both obstetric global packages and gynecologic surgical coding. Our team manages the global antepartum/delivery/postpartum bundle correctly, captures high-risk add-ons, and codes every gynecologic procedure to the right approach and level.

We serve ob/gyn practices in all 50 states, starting at 2.49% of collections. Our credentialing team handles payer enrollment, and our A/R specialists recover aging claims.

OB/GYN Billing by State

We handle ob/gyn billing in all 50 states. The 2026 Medicare allowables for ob/gyn CPT codes in every state are in the fee table above. Open any state below for its full payer environment, Medicaid rules, and Medicare MAC policies.

CaliforniaTexasFloridaNew YorkPennsylvaniaIllinoisOhioGeorgiaNorth CarolinaMichiganNew JerseyVirginiaMassachusettsArizonaTennesseeMarylandIndianaMissouriWisconsinColorado
View all 50 states

Related Resources

Medical Billing & Coding ServicesA/R Recovery ServicesCredentialing & ContractingCase Studies & ResultsPricing

Frequently Asked Questions

We track all 13 antepartum visits, manage the global period, and correctly bill high-risk visits and complications outside the package.
Yes. Hysterectomy (all approaches), laparoscopy, hysteroscopy, and office procedures with correct modifier and approach coding.
Yes. We code OB ultrasounds with proper gestational timing and medical necessity documentation.

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