CPT59400

Vaginal Delivery (Global) Cost in New York

Obstetrical care

$2,472.09New York physician fee2026 Medicare office rate
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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New York Medicare physician rate (2026)

+11.6% vs national

Average of 5 localities. Office range $2,078.59–$2,713.70.

New York (Hospital)
$2,472.09
Facility physician fee
Private plan est.
$3,214–$4,944
~130–200% of Medicare
Cash / self-pay est.
$1,978–$3,708
~80–150% of Medicare

Your ZIP in New York

New York's multiple localities make a ZIP-level check essential: compare Manhattan, Queens and the outer boroughs, Long Island, the Hudson Valley near Poughkeepsie, and upstate cities like Buffalo, Rochester, Syracuse, and Albany.

What vaginal delivery (global) costs at hospitals near you

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

National office$2,214.48
National hospital (physician)$2,214.48
New York vs national12% above the national office rate of $2,214.48

Where New York ranks for this CPT

Rank (lowest physician fee first)#48 of 51
Lowest stateWisconsin ($1,944.55)
Highest stateAlaska ($2,715.06)

CPT 59400 by New York locality

LocalityOffice
nyc suburbs/long island$2,713.70
manhattan$2,601.38
queens$2,563.22
poughkpsie/n nyc suburbs$2,403.55
rest of new york$2,078.59

PE GPCI ranges from 0.950 to 1.189 in New York. That index is why the same CPT is not one price statewide.

Vaginal Delivery (Global) and how New York is priced

New York has one of the most complex locality maps in the country, with around five payment areas: Manhattan is its own locality, Queens is separately priced, the NYC suburbs and Long Island form another high-cost locality, the Poughkeepsie area has its own, and the rest of the state, including Buffalo, Rochester, Syracuse, and Albany, shares a distinctly lower-priced upstate locality. The spread between Manhattan and upstate adjustments is among the widest within any state. A knee MRI or office visit is approved at meaningfully different amounts in Manhattan, Mineola, and Rochester. Upstate New York prices closer to the Midwest than to the five boroughs.

New York City is a global medical capital with world-famous academic medical centers competing within blocks of each other, while upstate cities each center on their own regional academic hubs. Long Island and the lower Hudson Valley support dense suburban hospital markets of their own. The upstate-downstate divide runs through everything in New York health care, including what providers charge and what patients can access locally.

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 York: questions

The 2026 Medicare physician office rate for CPT 59400 averages $2,472.09 across 5 New York localities, from $2,078.59 in REST OF NEW YORK to $2,713.70 in NYC SUBURBS/LONG ISLAND. The hospital physician rate averages $2,472.09. Enter a ZIP for the exact locality.

Yes. CMS splits New York into 5 payment localities. For this CPT the office physician fee spans $635.11 from the lowest to highest locality. New York's multiple localities make a ZIP-level check essential: compare Manhattan, Queens and the outer boroughs, Long Island, the Hudson Valley near Poughkeepsie, and upstate cities like Buffalo, Rochester, Syracuse, and Albany.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $494 for the office physician line or $494 for the hospital physician line in New York. Medigap may cover that 20%. This is not the hospital facility fee.

No. $2,472.09 is the Medicare physician allowed amount for CPT 59400. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. New York ranks #48 of 51 states on this physician line (12% 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.