CPT59400

Vaginal Delivery (Global) Cost in District of Columbia

Obstetrical care

$2,432.53District of Columbia physician fee2026 Medicare office rate
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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District of Columbia Medicare physician rate (2026)

+9.8% vs national

Single statewide locality.

District of Columbia (Hospital)
$2,432.53
Facility physician fee
Private plan est.
$3,162–$4,865
~130–200% of Medicare
Cash / self-pay est.
$1,946–$3,649
~80–150% of Medicare

Your ZIP in District of Columbia

Enter a ZIP code to see how the DC locality applies to your address, whether you are in the District itself, Bethesda or Silver Spring on the Maryland side, or Arlington and Alexandria in Virginia.

What vaginal delivery (global) costs at hospitals near you

Everything above is a national average. The hospital you pick in District of Columbia moves the bill more than anything else you control.

Locked

Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

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What these numbers are

Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery centre rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again.

National vs District of Columbia

National office$2,214.48
National hospital (physician)$2,214.48
District of Columbia vs national10% above the national office rate of $2,214.48

Where District of Columbia ranks for this CPT

Rank (lowest physician fee first)#47 of 51
Lowest stateWisconsin ($1,944.55)
Highest stateAlaska ($2,715.06)

Vaginal Delivery (Global) and how District of Columbia is priced

The District of Columbia is unusual in the fee schedule: it forms its own high-cost locality that reaches beyond the city line to cover close-in Maryland and Virginia suburbs, including areas such as Montgomery and Prince George's counties and the Arlington and Alexandria side of the Potomac. Its geographic indices are among the highest in the country, reflecting the region's wages and office costs. As a result, DC-area Medicare-approved amounts run well above those in the rest of Maryland or Virginia, and the boundary of that locality can matter more than the state line. A patient in Bethesda is priced with Washington, not with Baltimore.

The Washington area is dense with hospitals, including multiple academic medical centers and large regional systems competing across the district and its suburbs. That density gives patients real choice within a short distance, which is rare in American health care. Federal employment also means an unusually well-insured population, so cash-pay and Medicare-rate comparisons are most useful for those outside employer coverage.

This procedure: This code is not a single procedure but the entire package of routine pregnancy care with a vaginal birth: all standard prenatal visits, the delivery itself including any needed episiotomy or forceps assistance, and postpartum checkups. Labor and delivery happen in a hospital or birth center, and the global code represents roughly ten months of care by the obstetrician or midwifery practice. The hospital stay for an uncomplicated vaginal birth is typically one to two nights.

What Is Vaginal Delivery (Global)?

This code is not a single procedure but the entire package of routine pregnancy care with a vaginal birth: all standard prenatal visits, the delivery itself including any needed episiotomy or forceps assistance, and postpartum checkups. Labor and delivery happen in a hospital or birth center, and the global code represents roughly ten months of care by the obstetrician or midwifery practice. The hospital stay for an uncomplicated vaginal birth is typically one to two nights.

What Affects the Cost

  • The hospital's facility charges for labor, delivery, and the postpartum stay are separate from and usually larger than the physician's global fee.
  • An epidural is billed by the anesthesiologist as an entirely separate charge.
  • Your newborn generates a second, separate hospital account from the moment of birth, including nursery or NICU care and pediatrician visits.
  • Ultrasounds, lab panels, and genetic screening during pregnancy are billed outside the global fee, visit by visit.
  • Extra visits for complications like gestational diabetes or hypertension fall outside routine prenatal care and are billed additionally.
  • If labor ends in an unplanned cesarean, the physician claim converts to the cesarean global code at a higher rate and the hospital stay lengthens.

Questions to Ask Before Booking

  • 1.What does your global fee include, and which common services, like ultrasounds and labs, will be billed separately?
  • 2.What are the hospital's typical facility charges for a vaginal delivery and postpartum stay?
  • 3.Is the anesthesiology group that places epidurals at your hospital in my network?
  • 4.How is the baby's hospital care billed, and what do I need to do to enroll the baby on my insurance?
  • 5.If I end up needing a cesarean, how do the physician and hospital charges change?

Vaginal Delivery (Global) in District of Columbia: questions

District of Columbia is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 59400 is $2,432.53 in an office and $2,432.53 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.

Not on the physician fee schedule. District of Columbia uses one locality, so the Medicare physician rate is the same from one end of the state to the other. What still changes is site of service (office vs hospital) and any facility fee the hospital bills on its own claim.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $487 for the office physician line or $487 for the hospital physician line in District of Columbia. Medigap may cover that 20%. This is not the hospital facility fee.

No. $2,432.53 is the Medicare physician allowed amount for CPT 59400. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. District of Columbia ranks #47 of 51 states on this physician line (10% above the national office rate of $2,214.48).

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.