CPT 59400 vs. 59431: What Changes for OB-GYN Billing in 2027

For years, OB-GYN practices have billed prenatal visits, delivery, and routine postpartum care together under CPT 59400. That changes on January 1, 2027, when the code is deleted as part of the new maternity billing structure.

Under the updated CPT rules, antepartum care, labor management, delivery, and postpartum care are reported separately using the applicable codes. CPT 59431 is part of the new code set, but it does not replace every service previously included in the global maternity package.

For your practice, the change means reviewing how each service is documented and billed before 2027 claims go out. 

What does the 59400 CPT code Cover Today 

The 59400 cpt code description defines the global obstetric package for routine vaginal delivery. It bundles three phases of care into one payment. Those phases are prenatal care (13 or more visits), vaginal delivery with or without episiotomy, and follow-up care for up to six weeks after delivery.

When an OB-GYN submits a claim with CPT code 59400, the payer processes it as one payment for the entire pregnancy. Medicare pays roughly $2,214 for this code, based on a total RVU of 66.30 and the 2026 conversion factor of $33.40. Most commercial payers pay 15% to 25% more than that.

CPT 59400 brings everything together under one code, one claim, and one payment. That changes on January 1, 2027.

Why CPT 59400 is being deleted in 2027

The traditional global maternity billing model was designed to cover pregnancy care under one package. But OB-GYN practices do not always provide every stage of care to the same patient. A patient may switch providers, receive specialist care, or deliver at a different hospital.

Starting January 1, 2027, the AMA is replacing this approach with separate reporting for antepartum care, labor management, delivery, and postpartum care. The change is intended to better reflect how maternity care is delivered and help practices report the services they actually provide.

For OB-GYN practices, this means adjusting billing workflows to match the new structure. The AMA's CPT 2027 Maternity Care Services Overview explains the code changes and reporting requirements.

How CPT 59431 replaces the delivery portion of 59400

CPT 59431 is the new code for vaginal delivery. It covers the delivery itself, including episiotomy and repair of first- or second-degree lacerations by the delivering provider. It also includes routine same-day postpartum care.

That's it. No antepartum visits. No weeks of postpartum follow-ups. Just the delivery and what happens in the hours right after it.

If the delivery is a vaginal birth after cesarean (VBAC), you use 59432 instead. For a primary cesarean, 59502. Repeat cesarean, 59503. Each delivery type now has its own standalone code.

Here's the biggest structural shift: under CPT 59400, you submitted one claim after the pregnancy was over. Under the new system, one pregnancy can generate 20 or more billable encounters across four separate phases. Practices that partner with an obgyn billing services team are already mapping these phases into their claim workflows so nothing breaks on day one.

Old Code (Deleted)	What It Covered	New Code(s)	What Changes
59400	Global vaginal delivery	59431 + E/M + 59080-59083	Unbundled into 4 phases
59409	Vaginal delivery only	59431	Delivery portion only
59410	Vaginal + postpartum	59431 + E/M	Postpartum billed separately
59510	Global cesarean	59502 + E/M + 59080-59083	Unbundled into 4 phases
59610	Global VBAC	59432 + E/M + 59080-59083	Unbundled into 4 phases

What to Do Before the CPT 59400 Deletion

The CPT 59400 deletion takes effect January 1, 2027. OB-GYN practices should review their billing setup now so the new codes, documentation requirements, and payer rules are in place before the first 2027 claim goes out.

●        Update EHR templates to capture labor complexity criteria (singleton vs. multiple, vertex vs. non-vertex, prior cesarean history) for every labor encounter

●        Rebuild superbills to remove all 17 deleted codes and add 59431, 59432, 59502, 59503, and the 59080-59083 labor management codes

●        Revise fee schedules once the CMS final rule is published (expected November 2026) with confirmed RVU values for each new code

●        Renegotiate payer contracts that reference deleted global codes like 59400 or 59510

●        Train billing staff on the 4-phase structure so claims are submitted correctly from day one

●        Identify patients with due dates in Q1 2027 whose antepartum care started under the old system; their 2026 visits follow current rules, but every 2027 encounter bills under the new codes

Missing any of these steps means denied claims in January. The transition doesn't come with a grace period. Clearinghouses will reject deleted codes for 2027 dates of service. The AMA has published official guidance on preparing for the CPT 2027 maternity care changes.

FAQ

1. Can I still bill CPT 59400 for deliveries in 2027?

No. CPT 59400 is deleted effective January 1, 2027. For vaginal deliveries, use the applicable new delivery code, such as CPT 59431, based on the service provided.

2. What are the changes in maternity billing for 2027?

Starting January 1, 2027, maternity billing separates antepartum care, labor management, delivery, and postpartum services. Providers must use the applicable CPT codes for each service.

3. What are the changes in the ICD-10 code set for FY 2027?

The FY 2027 ICD-10-CM updates took effect October 1, 2026. OB GYN Providers should review revised diagnosis codes, official coding guidelines, and documentation requirements before submitting claims.