OB/GYN CPT Reference

OB/GYN CPT Codes and Reimbursement Rates

OB/GYN billing spans prenatal care, labor and delivery, gynecological procedures, and preventive women health services across the full patient lifecycle.

Reviewed by MMBS Billing Review Team Last updated Mar 31, 2026 Published Mar 16, 2026
Get Your Free Assessment Explore the Guide
OB/GYN CPT Codes and Reimbursement Rates
01

Global OB package (59400 vaginal, 59510 cesarean) bundles antepartum + delivery + postpartum

02

Revenue for antepartum care is delayed until delivery. Track due dates for cash flow forecasting.

03

Well-woman exam + problem visit = preventive code + E/M with modifier 25

04

In-office gynecologic procedures (colposcopy, LEEP, biopsy) generate higher margins than hospital-based

Overview

Why OB/GYN CPT Codes Teams Need a Better Workflow

OB/GYN billing spans prenatal care, labor and delivery, gynecological procedures, and preventive women health services across the full patient lifecycle. The global obstetric package (59400-59622) is one of the most complex billing constructs in medicine, bundling antepartum visits, delivery, and postpartum care into a single reimbursement amount.

This reference covers the CPT codes used most frequently in OB/GYN practices. Each section addresses global package rules, carve-out procedure billing, gynecological surgery codes, and preventive screening billing to help your practice capture all billable services accurately throughout each phase of care.

Why OB/GYN CPT Codes Teams Need a Better Workflow
Challenges

Common OB/GYN CPT Codes Challenges We Solve

Every OB/GYN CPT Codes team deals with payer delays, coding nuance, and collection leakage.

Global OB package (59400 vaginal, 59510 cesarean) bundles antepartum + delivery + postpartum

The workflow has to support this issue before claim submission, or it turns into avoidable rework after the payer responds.

Revenue for antepartum care is delayed until delivery. Track due dates for cash flow forecasting.

When this area is inconsistent, denial rate, payment timing, and staff follow-up effort all get worse at the same time.

Well-woman exam + problem visit = preventive code + E/M with modifier 25

Tight documentation and coding controls here usually improve both reimbursement accuracy and operational speed.

In-office gynecologic procedures (colposcopy, LEEP, biopsy) generate higher margins than hospital-based

This is one of the first places revenue leakage shows up when specialty billing habits are not standardized.

Services

Complete OB/GYN CPT Codes Resources

Support spans the full revenue cycle.

Billing Process

Claim Denials

Revenue Cycle

Outsourcing

Coding Guide

OB/GYN Billing Hub

Coverage

Serving OB/GYN Billing Teams Nationwide

We support independent practices and growing provider organizations.

OB/GYN private practices

OB/GYN multisite groups

OB/GYN billing managers

OB/GYN owners and operators

Guide

The Complete Guide to OB/GYN CPT Codes

Quick answer

OB/GYN billing spans prenatal care, labor and delivery, gynecological procedures, and preventive women health services across the full patient lifecycle. The global obstetric package (59400-59622) is one of the most complex billing constructs in medicine, bundling antepartum visits, delivery, and postpartum care into a single reimbursement amount.

This reference covers the CPT codes used most frequently in OB/GYN practices. Each section addresses global package rules, carve-out procedure billing, gynecological surgery codes, and preventive screening billing to help your practice capture all billable services accurately throughout each phase of care.

OB/GYN CPT Code Categories

OB/GYN billing straddles two distinct service lines: obstetric care with its global packaging rules and gynecologic services billed per encounter. Understanding when the global obstetric package applies and when services are billed individually is the most critical distinction in OB/GYN coding. Getting this wrong either leaves revenue uncollected or creates compliance exposure from unbundling services that should be packaged.

Global Obstetric Package Codes

The global obstetric package bundles antepartum care, delivery, and postpartum care into a single code. Vaginal delivery (59400) reimburses approximately $2,300 under Medicare and includes all routine antepartum visits (typically 13), the delivery, and postpartum care through 6 weeks. Cesarean delivery (59510) reimburses approximately $2,700. Vaginal delivery after previous cesarean (59610) reimburses approximately $2,500.

The global package creates a timing challenge for billing. The practice does not submit the claim until after delivery, meaning revenue for months of antepartum care is delayed until the delivery event. Cash flow management requires tracking the expected delivery dates across the patient panel and forecasting the associated revenue.

Antepartum-Only and Postpartum-Only Codes

When a patient transfers care during pregnancy, the transferring provider bills antepartum-only codes based on the number of visits provided: 59425 (4-6 visits, approximately $450) or 59426 (7+ visits, approximately $750). The receiving provider bills the delivery and postpartum components. Postpartum-only care uses 59430 (approximately $200).

Gynecologic Procedure Codes

Gynecologic procedures are billed per encounter, not globally. Colposcopy with biopsy (57454) reimburses approximately $200. Endometrial biopsy (58100) reimburses approximately $135. LEEP procedure (57522) reimburses approximately $350. Hysteroscopy with biopsy (58558) reimburses approximately $450. These procedures generate significant revenue when performed in-office rather than in a hospital outpatient setting.

Preventive and E/M Visits

Annual well-woman exams use preventive visit codes (99384-99397 by age group) and include the pelvic exam, breast exam, and preventive counseling. When a problem is addressed during the same visit (abnormal bleeding, contraception management), an E/M code with modifier 25 can be billed in addition to the preventive code. This split billing is one of the most frequently missed revenue opportunities in OB/GYN.

Obstetric Ultrasound

OB ultrasound codes differ from general radiology ultrasound. First trimester ultrasound (76801) reimburses approximately $120. Detailed fetal anatomy scan (76811) reimburses approximately $195. Limited OB ultrasound (76815) reimburses approximately $70 and is used for focused assessments (fetal heart rate, amniotic fluid). Practices that own ultrasound equipment bill the global code; those using hospital equipment bill modifier 26 for professional interpretation only.

Common OB/GYN CPT Codes and Rates

CPT Code Description Medicare Rate (Approx.)
59400 Vaginal delivery, global package $2,300
59510 Cesarean delivery, global package $2,700
57454 Colposcopy with biopsy $200
58100 Endometrial biopsy $135
57522 LEEP procedure $350
76801 OB ultrasound, first trimester $120
76811 Detailed fetal anatomy scan $195
99395 Preventive visit, 18-39 years $155

Official sources

Use these checks with payer policy, coding documentation, and remittance data before changing claim workflows.

Common Questions

OB/GYN CPT Codes FAQ

Answers to the questions practice owners ask most often.

The global OB package (59400, 59510, 59610) includes all routine antepartum visits after the initial visit (typically 13 visits), the delivery (vaginal or cesarean), and postpartum care through 6 weeks. Complications, hospital admissions for conditions unrelated to normal pregnancy, and non-routine services are billed separately outside the global package.

Bill antepartum-only codes (59425 for 4-6 visits, 59426 for 7+) when the patient transfers to another provider before delivery. The number of antepartum visits provided determines the code. The receiving provider bills the delivery and postpartum components. If the patient transfers back before delivery, the original provider may bill the global package instead.

Not for routine antepartum care, which is included in the global package. However, if a complication arises during an antepartum visit that requires additional evaluation and management beyond routine care (gestational diabetes management, preeclampsia evaluation), the E/M visit for the complication can be billed separately with the appropriate complication diagnosis code and modifier 25.

If the practice owns the ultrasound equipment and the physician performs and interprets the study, bill the global OB ultrasound code (76801, 76805, 76811, 76815). If the physician only interprets images from hospital or external equipment, bill with modifier 26. Standard OB ultrasound at specific gestational ages is included in the global OB package under some payer policies. Check each payer to determine which ultrasounds are included vs. separately billable.

READY TO GET STARTED?

Start Billing Smarter for OB/GYN CPT Codes

Get a revenue review and a clear action plan tailored to your practice.

Get Your Free Assessment

HIPAA Compliant · No Upfront Fees · No Long-Term Contracts