CPT 2027 Eliminates Global Maternity Codes And Restructures OB Billing

AMA has released the complete CPT 2027 code set and published detailed implementation guidance for one of the largest maternity coding restructures in decades. 

Effective January 1, 2027, the traditional global obstetric coding framework is being substantially dismantled. AMA reports 35 affected codes — 17 deletions, 12 additions, and six revisions.

ACOG first announced the new structure in April 2026. AMA released the full code set on September 9 and published extensive FAQs and guideline documents on September 17.

Codes that got deleted

Seventeen codes are being deleted. The list includes several of the most familiar obstetric billing codes in current use.

• 59430 — postpartum care only
• 59525 — cesarean hysterectomy
• 59050 — fetal monitoring interpretation
• 59400, 59409, 59410 — global and component vaginal delivery
• 59510, 59514, 59515 — cesarean/global or component maternity
• 59425, 59426 — antepartum-only packages (4-6 visits and 7+ visits)
• 59610, 59612, 59614, 59618, 59620, 59622 — care and delivery following previous cesarean

AMA states that deleted codes become invalid for dates of service beginning January 1, 2027. Claims systems and clearinghouses should reject them.

Phase-specific reporting

The restructuring moves maternity billing from a package-oriented model toward encounter- and phase-specific reporting.

Prenatal care no longer uses the 59425/59426 visit-package structure.

Beginning January 1, each antepartum encounter is reported with the appropriate E/M code based on medical decision-making or time. Pregnancy can count as a condition addressed, but E/M level selection still requires applying the full MDM framework.

Labor management receives four entirely new codes — 59080 and 59081 for initial-day straightforward and complex labor, and 59082 and 59083 for subsequent-day straightforward and complex labor. 

AMA’s guidelines explicitly state that delivery care does not include labor management work, so both can be reported when legitimately performed. Long labor alone does not automatically qualify as complex — specific clinical criteria apply.

Delivery receives a streamlined code structure.

• 59431 — vaginal delivery
• 59502 — primary cesarean
• 59432 — vaginal delivery after previous cesarean (the new VBAC code)
• 59433 / 59434 — third- and fourth-degree laceration repairs (reported separately)
• 59504 — cesarean hysterectomy
• 59503 — repeat cesarean

A planned cesarean when the patient is not in labor does not generate a labor-management code. First- and second-degree laceration repairs by the delivering clinician remain included in the delivery service.

Postpartum care on the delivery date remains included in the delivery service. Care on subsequent days — inpatient, discharge, outpatient follow-up — moves to the appropriate E/M service. New code 59623 separately reports uterine tamponade for postpartum hemorrhage (not pharmacologic management).

Pregnancies crossing January 1

AMA’s transition guidance is explicit. For prenatal encounters during 2026, existing rules apply — 59425 for four to six visits, 59426 for seven or more. For encounters on or after January 1, 2027, each visit uses the appropriate E/M code.

A patient with five prenatal visits in late 2026 and additional visits in 2027 before delivery would generate 59425 for the 2026 services and individual E/M claims for the 2027 encounters. Practices need to identify pregnancies already underway that will cross the transition date.

Payment is not final

The CPT codes are set. The money side is still open:

Commercial payer implementation varies. 

Cigna has stated it is not changing its maternity billing guidance at this time and is evaluating the transition. Other payers may differ. 

Practices should verify each payer’s transition policy separately rather than assuming a single universal approach.