Complete CPT Code Guide for OB/GYN 2026

OB/GYN billing covers one of the broadest CPT code ranges in any medical specialty — from routine preventive care to complex robotic surgery, from routine prenatal visits to high-risk delivery management. This guide covers the most important codes your practice needs in 2026.

Global Maternity CPT Codes

The global maternity package codes cover bundled antepartum, delivery, and postpartum care. The correct code depends on the delivery type and which care components your practice provided.

59400 — Routine obstetric care including antepartum care, vaginal delivery, and postpartum care. Used when you provided all components.

59410 — Vaginal delivery only (with or without episiotomy, forceps). Use when another provider handled antepartum or postpartum care.

59409 — Vaginal delivery only — use this when antepartum was not provided by your practice.

59425 — Antepartum care only; 4–6 visits.

59426 — Antepartum care only; 7 or more visits.

59430 — Postpartum care only. Billable when you did not deliver or provide antepartum care.

59510 — Routine obstetric care including antepartum care, cesarean delivery, and postpartum care.

59514 — Cesarean delivery only.

59515 — Cesarean delivery only, with postpartum care.

59610 — VBAC with antepartum and postpartum care.

59618 — VBAC — attempted delivery after prior cesarean, resulting in cesarean delivery, with antepartum and postpartum care.

GYN Surgery CPT Codes

Hysterectomy

58150 — Total abdominal hysterectomy

58260 — Vaginal hysterectomy, uterus ≤250g

58570 — Laparoscopic-assisted vaginal hysterectomy (LAVH)

58571 — Laparoscopic-assisted vaginal hysterectomy with BSO

58572 — Laparoscopic total hysterectomy, uterus >250g

58573 — Laparoscopic total hysterectomy, uterus >250g, with removal of tube(s) and/or ovary(s)

Myomectomy

58140 — Myomectomy, abdominal approach

58545 — Laparoscopic myomectomy, single intramural or subserous myoma

58546 — Laparoscopic myomectomy, multiple fibroids

Laparoscopy

58661 — Laparoscopic removal of adnexal structure

58662 — Laparoscopic fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface

58670 — Laparoscopic fulguration of oviducts

In-Office Procedures

57454 — Colposcopy with biopsy(ies) of the cervix

57461 — Colposcopy with loop electrode excision procedure (LEEP)

57505 — Endocervical curettage

58300 — Insertion of IUD

58301 — Removal of IUD

58558 — Hysteroscopy, surgical with sampling and/or polypectomy

E/M Codes (2024 AMA Guidelines Still Active in 2026)

The 2024 AMA E/M revision changed how visit complexity is determined. MDM (Medical Decision Making) is now the primary driver — not the physical exam.

99202 — New patient, straightforward MDM (10–19 min)

99203 — New patient, low complexity (20–29 min)

99204 — New patient, moderate complexity (30–39 min)

99205 — New patient, high complexity (40–54 min)

99211 — Established patient, minimal (nurse/MA visit)

99212 — Established patient, straightforward (10–19 min)

99213 — Established patient, low complexity (20–29 min)

99214 — Established patient, moderate complexity (30–39 min)

99215 — Established patient, high complexity (40–54 min)

Key MDM principle for OB/GYN: A patient presenting with multiple chronic conditions (e.g., gestational diabetes + hypertension + advanced maternal age) at a prenatal visit can legitimately be coded at 99214 or 99215 based on complexity — not just time.

Critical Modifiers for OB/GYN

25 — Significant, separately identifiable E/M service on the same day as a procedure. Attach to the E/M code when both a procedure and a separate E/M decision were made on the same date.

51 — Multiple procedures. Appended to secondary procedures when two or more procedures performed during the same session.

59 — Distinct procedural service. Use when procedures are at different anatomical sites, different encounters, or not ordinarily billed together but clinically justified.

XE, XS, XP, XU — The X modifiers (CMS preferred over 59 for Medicare): XE (separate encounter), XS (separate structure), XP (separate practitioner), XU (unusual non-overlapping service).

22 — Increased procedural services. Document the extra work in the operative report — this modifier requires a report, not just a modifier.

TC / 26 — Technical Component / Professional Component. Used when billing global, professional-only, or technical-only components of procedures.

Preventive Care Codes

99385–99387 — New patient preventive care, various age ranges

99391–99397 — Established patient preventive care, various age ranges

G0101 — Cervical/vaginal cancer screening (pelvic + pap)

Q0091 — Obtaining cervical/vaginal smear

2026 Key Reminders

1. IUD placement still requires correct J-code for the device supply (J7296–J7302) billed alongside 58300

2. Global maternity codes require documentation of which visits are included — always note visit count in the delivery summary

3. Modifier 59 vs. X modifiers: most commercial payers accept 59; Medicare prefers X modifiers for new unbundling situations

4. Telehealth codes (99213–99215 with modifier 95 or GT) are permanently covered for most OB/GYN services as of 2026

This guide covers core codes — your practice's specific code mix should be reviewed quarterly in a coding audit to ensure no revenue is being left on the table.