CPT 59514
Global MMM ActiveCesarean delivery only
CPT 59514 Billing & Documentation Guide
CPT code 59514 (Cesarean delivery only) is classified under Surgery (Urinary/Reproductive) with a global period indicator of MMM. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 16.13, a non-facility practice expense RVU of 3.52, and a malpractice RVU of 5.01, a total non-facility RVU of 24.66 and facility RVU of 24.66. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $815.7, though rates vary from $702.93 to $1084.35 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 59514, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 59514 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Maternity codes (separate billing rules)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 59514 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 59514
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 16.13 | 16.13 |
| Practice Expense RVU | 3.52 | 3.52 |
| Malpractice RVU | 5.01 | 5.01 |
| Total RVU | 24.66 | 24.66 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 59514
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $787.93 | $787.93 | $766.47 - $857.25 | 29 |
| Florida | $982.47 | $982.47 | $902.66 - $1084.35 | 3 |
| Georgia | $851.95 | $851.95 | $843.1 - $860.8 | 2 |
| Illinois | $974.03 | $974.03 | $907.65 - $1044.73 | 4 |
| Michigan | $884.69 | $884.69 | $835.02 - $934.35 | 2 |
| North Carolina | $755.38 | $755.38 | $755.38 - $755.38 | 1 |
| New York | $922.97 | $922.97 | $768.09 - $1023.78 | 5 |
| Ohio | $814.78 | $814.78 | $814.78 - $814.78 | 1 |
| Pennsylvania | $837.65 | $837.65 | $804.82 - $870.48 | 2 |
| Texas | $812.9 | $812.9 | $790.1 - $890.07 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 59514
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 59514 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0021T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 01958 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01961 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01968 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0230T | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 12001 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 59514
What does CPT code 59514 mean? +
CPT code 59514 represents: Cesarean delivery only. It's in the Surgery (Urinary/Reproductive) category with a global period of MMM.
What is the Medicare reimbursement for CPT 59514? +
The 2026 Medicare national average non-facility payment for CPT 59514 is $815.7. Rates range from $702.93 to $1084.35 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 59514? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 59514? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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