CPT59400

Vaginal Delivery (Global) Cost in New Jersey

Obstetrical care

$2,386.12New Jersey physician fee2026 Medicare office rate
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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New Jersey Medicare physician rate (2026)

+7.8% vs national

Average of 2 localities. Office range $2,355.71–$2,416.53.

New Jersey (Hospital)
$2,386.12
Facility physician fee
Private plan est.
$3,102–$4,772
~130–200% of Medicare
Cash / self-pay est.
$1,909–$3,579
~80–150% of Medicare

Your ZIP in New Jersey

Look up your ZIP code to see whether northern or rest-of-state New Jersey pricing applies, from Newark, Jersey City, and Bergen County down to Trenton, Cherry Hill, and the Jersey Shore.

What vaginal delivery (global) costs at hospitals near you

Everything above is a national average. The hospital you pick in New Jersey 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 New Jersey

National office$2,214.48
National hospital (physician)$2,214.48
New Jersey vs national8% above the national office rate of $2,214.48

Where New Jersey ranks for this CPT

Rank (lowest physician fee first)#46 of 51
Lowest stateWisconsin ($1,944.55)
Highest stateAlaska ($2,715.06)

CPT 59400 by New Jersey locality

LocalityOffice
northern nj$2,416.53
rest of new jersey$2,355.71

PE GPCI ranges from 1.092 to 1.160 in New Jersey. That index is why the same CPT is not one price statewide.

Vaginal Delivery (Global) and how New Jersey is priced

New Jersey is split into two payment localities: northern New Jersey, which carries higher adjustments befitting its position in the New York metropolitan orbit, and the rest of the state to the south. Both localities price above the national average, but the northern one ranks among the more expensive in the country. The dividing line means a procedure in Bergen County is approved at a higher amount than the same one in Cherry Hill or along the shore. South Jersey's pricing gravity pulls toward Philadelphia even though its locality is its own.

New Jersey may be the ultimate cross-border care state: North Jersey residents flow into Manhattan hospitals, South Jersey residents into Philadelphia's academic centers, and the state's own large systems compete hard in between. Dense population means most residents have multiple hospitals within a short drive, which is real negotiating leverage for a cash-pay patient. The shore counties see seasonal population surges that strain capacity each summer.

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 New Jersey: questions

The 2026 Medicare physician office rate for CPT 59400 averages $2,386.12 across 2 New Jersey localities, from $2,355.71 in REST OF NEW JERSEY to $2,416.53 in NORTHERN NJ. The hospital physician rate averages $2,386.12. Enter a ZIP for the exact locality.

Yes. CMS splits New Jersey into 2 payment localities. For this CPT the office physician fee spans $60.82 from the lowest to highest locality. Look up your ZIP code to see whether northern or rest-of-state New Jersey pricing applies, from Newark, Jersey City, and Bergen County down to Trenton, Cherry Hill, and the Jersey Shore.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $477 for the office physician line or $477 for the hospital physician line in New Jersey. Medigap may cover that 20%. This is not the hospital facility fee.

No. $2,386.12 is the Medicare physician allowed amount for CPT 59400. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. New Jersey ranks #46 of 51 states on this physician line (8% 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.