CPT59510

Cesarean Delivery (Global) Cost in Pennsylvania

Cesarean delivery

$2,501.94Pennsylvania physician fee2026 Medicare office rate
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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Pennsylvania Medicare physician rate (2026)

+1.2% vs national

Average of 2 localities. Office range $2,394.68–$2,609.21.

Pennsylvania (Hospital)
$2,501.94
Facility physician fee
Private plan est.
$3,253–$5,004
~130–200% of Medicare
Cash / self-pay est.
$2,002–$3,753
~80–150% of Medicare

Your ZIP in Pennsylvania

Look up your ZIP to see whether metro Philadelphia or rest-of-state pricing applies, from Philadelphia and its collar counties to Pittsburgh, Harrisburg, Allentown, Scranton, Erie, and the rural center.

What cesarean delivery (global) costs at hospitals near you

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

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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 Pennsylvania

National office$2,473.34
National hospital (physician)$2,473.34
Pennsylvania vs nationalwithin 2% of the national office rate of $2,473.34

Where Pennsylvania ranks for this CPT

Rank (lowest physician fee first)#36 of 51
Lowest stateWisconsin ($2,144.81)
Highest stateAlaska ($3,007.35)

CPT 59510 by Pennsylvania locality

LocalityOffice
metropolitan philadelphia$2,609.21
rest of pennsylvania$2,394.68

PE GPCI ranges from 0.918 to 1.041 in Pennsylvania. That index is why the same CPT is not one price statewide.

Cesarean Delivery (Global) and how Pennsylvania is priced

Pennsylvania's fee schedule separates metro Philadelphia from the rest of the state, giving the southeast its own higher-cost locality while Pittsburgh, Harrisburg, Allentown, Erie, and rural Pennsylvania share rest-of-state adjustments. That means the state's second-largest medical market, Pittsburgh, is priced with rural counties rather than with Philadelphia. The Philadelphia locality's premium reflects the metro's wage and rent levels, which lead the state by a wide margin. For patients, the key locality question in Pennsylvania is simply whether care happens in the Philadelphia area.

Philadelphia is one of America's historic centers of academic medicine, dense with teaching hospitals, while Pittsburgh is dominated by a pair of large integrated systems whose rivalry has defined that market for years. The rural middle of the state, sometimes called the T, has far fewer options, and hospital closures there have drawn statewide attention. Residents near the edges use New York, Baltimore, or Ohio providers when convenient.

This procedure: This is the global maternity package for a planned or unplanned cesarean birth: routine prenatal visits, the cesarean delivery, and postpartum care in a single physician fee. A cesarean is major abdominal surgery performed in an operating room under spinal or epidural anesthesia, usually taking under an hour, with the parent awake for the birth. The hospital stay is longer than for a vaginal birth, typically two to four nights, with a six-week surgical recovery at home.

What Is Cesarean Delivery (Global)?

This is the global maternity package for a planned or unplanned cesarean birth: routine prenatal visits, the cesarean delivery, and postpartum care in a single physician fee. A cesarean is major abdominal surgery performed in an operating room under spinal or epidural anesthesia, usually taking under an hour, with the parent awake for the birth. The hospital stay is longer than for a vaginal birth, typically two to four nights, with a six-week surgical recovery at home.

What Affects the Cost

  • Hospital facility charges are substantially higher than for vaginal delivery, driven by operating room time and the longer inpatient stay.
  • The anesthesiologist bills separately for the spinal or epidural and for attending the surgery.
  • The newborn's own hospital account starts at birth, and cesarean deliveries have higher rates of brief NICU observation, which is billed at NICU rates.
  • An assistant surgeon, common in cesareans, may bill an additional professional fee.
  • Prenatal ultrasounds, labs, and any high-risk specialist visits are billed outside the global package.
  • A scheduled cesarean is generally cheaper than one that follows a long, fully billed labor with an epidural already running.

Questions to Ask Before Booking

  • 1.What are the hospital's facility charges for a cesarean, including the typical length of stay?
  • 2.Will an assistant surgeon be present, and do they bill separately under my plan?
  • 3.Is the anesthesiology group in network, and what does the spinal or epidural cost?
  • 4.How likely is NICU observation for my situation, and how would that be billed for the baby?
  • 5.If I am attempting vaginal birth first, how do charges stack if it converts to a cesarean?

Cesarean Delivery (Global) in Pennsylvania: questions

The 2026 Medicare physician office rate for CPT 59510 averages $2,501.94 across 2 Pennsylvania localities, from $2,394.68 in REST OF PENNSYLVANIA to $2,609.21 in METROPOLITAN PHILADELPHIA. The hospital physician rate averages $2,501.94. Enter a ZIP for the exact locality.

Yes. CMS splits Pennsylvania into 2 payment localities. For this CPT the office physician fee spans $214.53 from the lowest to highest locality. Look up your ZIP to see whether metro Philadelphia or rest-of-state pricing applies, from Philadelphia and its collar counties to Pittsburgh, Harrisburg, Allentown, Scranton, Erie, and the rural center.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $500 for the office physician line or $500 for the hospital physician line in Pennsylvania. Medigap may cover that 20%. This is not the hospital facility fee.

No. $2,501.94 is the Medicare physician allowed amount for CPT 59510. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. Pennsylvania ranks #36 of 51 states on this physician line (within 2% of the national office rate of $2,473.34).

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.