CPT 59610
Global MMM ActiveVbac delivery
CPT 59610 Billing & Documentation Guide
CPT code 59610 (Vbac delivery) is classified under Surgery (Urinary/Reproductive) with a global period indicator of MMM. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 38.71, a non-facility practice expense RVU of 18.63, and a malpractice RVU of 12.44, a total non-facility RVU of 69.78 and facility RVU of 69.78. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $2324.42, though rates vary from $2017.05 to $2991.54 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 59610, 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 59610 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 59610 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 59610
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 38.71 | 38.71 |
| Practice Expense RVU | 18.63 | 18.63 |
| Malpractice RVU | 12.44 | 12.44 |
| Total RVU | 69.78 | 69.78 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 59610
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 | $2300.92 | $2300.92 | $2219.64 - $2555.18 | 29 |
| Florida | $2726.14 | $2726.14 | $2512.34 - $2991.54 | 3 |
| Georgia | $2385.68 | $2385.68 | $2343.29 - $2428.07 | 2 |
| Illinois | $2692.77 | $2692.77 | $2510.51 - $2880.96 | 4 |
| Michigan | $2462.08 | $2462.08 | $2330.18 - $2593.97 | 2 |
| North Carolina | $2139.03 | $2139.03 | $2139.03 - $2139.03 | 1 |
| New York | $2613.35 | $2613.35 | $2176.2 - $2887.16 | 5 |
| Ohio | $2279.9 | $2279.9 | $2279.9 - $2279.9 | 1 |
| Pennsylvania | $2358.27 | $2358.27 | $2256.84 - $2459.69 | 2 |
| Texas | $2298.63 | $2298.63 | $2244.05 - $2492.93 | 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 59610
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 59610 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 |
| 01960 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01967 | 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 |
| 11000 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 59610
What does CPT code 59610 mean? +
CPT code 59610 represents: Vbac delivery. It's in the Surgery (Urinary/Reproductive) category with a global period of MMM.
What is the Medicare reimbursement for CPT 59610? +
The 2026 Medicare national average non-facility payment for CPT 59610 is $2324.42. Rates range from $2017.05 to $2991.54 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 59610? +
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 59610? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team