OB/GYN CPT Codes: The Complete 2026 to 2027 Billing Guide

OB/GYN CPT codes look stable right now, but they carry an expiration date most billing teams haven't clocked yet.

Starting January 1, 2027, CPT codes for maternity care split into two tracks. One code set covers care through the end of this year. A different, more granular set takes over for anything billed after the new year, and the two don't overlap the way a normal annual code update does.

ACOG already told payers to start moving antepartum billing to E/M codes with modifier TH attached. The recommended start date for that shift was September 1, 2026. That date has passed. If your billing team hasn't made the switch yet, the practice is already behind.

This guide covers the OB/GYN CPT codes you're billing today, the exact codes replacing them in 2027, and the specific places claims are getting denied right now.

OB/GYN CPT Codes at a Glance

Pull the code you need from the table below, then jump to the section that covers it in full.

What's Changing on January 1, 2027, and What to Bill Right Now

Why the Global Maternity Code Is Going Away

A single code has represented nine months of pregnancy care for more than three decades. That code worked when one doctor saw a patient from her first prenatal visit through her six week checkup. It stopped working once patients started seeing multiple providers across a single pregnancy.

The American Medical Association's CPT Editorial Panel approved a full restructuring of maternity care codes on April 23, 2026, after nearly two years of work with ACOG and other specialty societies. The panel replaced the global package with four separately billed phases: antepartum, labor management, delivery, and postpartum.

Three real-world patterns drove the change. Patients now see multiple, sometimes unaffiliated providers across a single pregnancy. Rural patients get transferred to higher-acuity centers mid-pregnancy more often than the old code assumed. Antepartum care increasingly follows a tailored visit schedule with telehealth built in, replacing the traditional thirteen-visit pattern the global code was built around. For a full walkthrough of the change directly from the source, see AMA's coding primer webinar on the restructure.

The Exact Codes Changing in 2027

Thirty-five OB/GYN CPT codes change in total. The AMA deletes seventeen, adds twelve, and revises six.

Five new codes are worth knowing by name. 59080 and 59081 cover initial day labor management, split by straightforward or complex. 59082 and 59083 cover subsequent days using the same split. 59433 and 59434 report third and fourth degree laceration repair, now billed apart from the delivery code itself. 59504 covers a hysterectomy performed during the same session as a cesarean delivery. 59623 is a new procedure code for uterine tamponade, used to manage postpartum hemorrhage with a balloon, catheter, or packing device. It does not cover pharmacologic management of hemorrhage. This entire mapping comes from AMA's published 2027 maternity coding guidelines.

What to Bill for Antepartum Visits Right Now

ACOG's guidance calls for antepartum billing to move to E/M codes with modifier TH attached, and it set September 1, 2026 as the date to start, a detail confirmed directly in ACOG's obstetric coding guidance. Practices that made the switch on schedule are already running clean. Practices that haven't are building a backlog of claims that will need correction before January.

A pregnancy that starts antepartum care in 2026 and delivers in 2027 needs two different billing approaches inside one pregnancy. Early visits follow the current rules. The delivery and anything after it follow the 2027 phase structure. The first wave of 2027 denials will start here, months before the calendar turns.

A specialty-specific coding review catches exactly this kind of gap, before a payer does. See how MedSole reviews OB/GYN coding.

Gynecology Codes Don't Change

Hysterectomy, colposcopy, IUD management, and every other gynecology code in this OB/GYN CPT codes guide stays exactly as it is. The 2027 restructuring touches maternity care only.

Global OB Package Codes You're Still Billing Today

Among all the OB/GYN CPT codes in active use, four global codes carry practices through the rest of 2026: 59400, 59510, 59610, and 59618. Each one bundles three phases of pregnancy care into a single payment, and each one comes with a strict included and excluded list.

What's Included in the Global Package

The global package covers routine antepartum visits, uncomplicated labor management, the delivery itself, first or second degree laceration repair, and routine postpartum care within the standard window. A single provider or group bills all of it under one code, one time.

What's Excluded from the Global Package

Ultrasounds, amniocentesis, non-stress tests, and external cephalic version all bill separately from the global code. So does care for a condition unrelated to the pregnancy, like a sinus infection treated during a prenatal visit. Any antepartum visit count that falls outside the routine pattern moves to itemized billing instead, which the next section covers.

The global code depends on one condition holding true: a single provider or group, under one tax ID, delivering all three phases of care to one payer. Break any part of that condition and itemized billing takes over.

When the Global Code Doesn't Apply: Itemized OB Codes

A patient transfers practices mid-pregnancy. A different provider handles the delivery. Care ends before the six week postpartum visit happens. Any of these situations moves a claim out of the global package and into a different corner of OB/GYN CPT codes: the itemized set.

That last row catches more practices than it should. A patient seen once, twice, or three times before transferring gets billed with standard E/M codes for each visit. Code 59425 requires a minimum of four visits, and billing it for three creates a denial that won't survive an appeal.

A root-cause denial review catches a visit-count mismatch like this while the claim is still in queue, before it turns into a denial. See how MedSole's denial review process works.

Obstetric Ultrasound CPT Codes: Which One, and Can You Bill Two Together

Ultrasound codes are the OB/GYN CPT codes billing teams look up most often, and the wrong one gets picked more than any other category in this guide.

76801 vs 76805: Which Trimester, Which Code

CPT 76801 covers a complete transabdominal ultrasound before 14 weeks 0 days of pregnancy. CPT 76805 takes over at 14 weeks 0 days and continues through the rest of the pregnancy. Gestational age at the time of the scan decides the code, independent of when the visit was scheduled.

76811 vs 76805: Standard Scan or Detailed Anatomy Survey

CPT 76811 is a higher tier of 76805, a detailed anatomy survey ordered only when a specific medical indication exists, such as a suspected fetal anomaly. Maternal-fetal medicine typically performs or supervises this scan, reserved for cases with that specific indication rather than routine second trimester screening.

76815, 76816, and 76817: Limited, Follow-Up, and Transvaginal

CPT 76815 is the limited scan, usable in any trimester when a single narrow question needs an answer, such as confirming a heartbeat or checking placental location. It also serves as the correct fallback when a first trimester scan was meant to be complete under 76801 but a required element couldn't be visualized and documented. CPT 76816 covers a follow-up or repeat scan later in the same pregnancy. CPT 76817 is the transvaginal approach, used when the transabdominal view alone doesn't answer the clinical question.

Can These Codes Be Billed Together

Many of these pairs can be billed on the same date, but only with separate, documented medical necessity for each one. A transabdominal scan followed by a transvaginal scan because the first view was insufficient supports billing both. A transabdominal scan followed by a transvaginal scan with no documented reason for the second one invites a bundling denial or a multiple-procedure reduction. The professional and technical component split matters here too, especially when one physician reads the images and a different facility performs the scan. Read the full technical component breakdown.

Pregnancy Loss and Miscarriage CPT Codes

CPT 59812 and CPT 59820 get confused, and the confusion costs real money on appeal. 59812 treats an incomplete abortion: the miscarriage has already started, and some tissue has passed, in any trimester. 59820 treats a missed abortion: the pregnancy has stopped developing, but nothing has passed yet, and this code applies only in the first trimester. CPT 59821 is the second trimester version of the same clinical picture, a distinction several billing guides skip.

CPT 59840 and CPT 59841 split by method rather than clinical status. 59840 reports an induced abortion by dilation and curettage. 59841 reports dilation and evacuation, typically used further into a pregnancy once suction alone can't complete the procedure. Every code number in this section is checked against the current CPT guideline language for these procedures.

One question decides the correct code across this category: has tissue already passed, and which trimester applies. The clinical status documented at the time of the procedure is what points a coder to the right one, well before the general term "miscarriage" enters the chart note.

Well-Woman and Preventive Exam CPT Codes

Well-woman and Pap smear codes get searched more than any other cluster of OB/GYN CPT codes in this guide, and they're also where a single reversed modifier causes the most damage.

Preventive Visit Codes by Age, 99384 to 99397

New patients get preventive visit codes 99384 through 99387, split into four age bands. Established patients get 99394 through 99397, using the same four bands: 12 to 17, 18 to 39, 40 to 64, and 65 and older. A patient counts as established if any physician in the same specialty and same group has seen her for a face-to-face visit within the past three years. Miss that window by even a day, and the visit reverts to a new-patient code.

Modifier 25 causes more denials in this category than any other error. When a patient comes in for a scheduled well-woman exam and the physician also addresses a separate, significant problem in the same visit, the problem-oriented E/M code carries modifier 25. The preventive code does not. Billing teams reverse this pairing often, and the reversal bundles the whole claim.

Pap Smear and Cervical Cytology Codes

CPT codes 88141 through 88175 cover cervical and vaginal cytology, and the specific code depends on the collection method and the screening tier used. For Medicare patients, the pathway looks different. Original Medicare doesn't pay for the standard 99384 through 99397 preventive codes at all, so two Medicare-specific codes fill that gap.

Medicare Specific Codes: Q0091 and G0101

Q0091 covers obtaining, preparing, and conveying a screening Pap smear to the lab. G0101 covers the pelvic and clinical breast exam. Medicare pays for both on a two-year cycle for average-risk patients, and annually for high-risk patients or those with an abnormal Pap result in the past three years. Bill G0101 alongside a same-day E/M service with modifier 25 attached, and don't report it on the same date as the routine 99384 through 99397 codes, since those already include the age-appropriate exam. CMS spells out the frequency rules directly in its own Medicare wellness visit coverage rules.

Add-on code 99459 sits next to this cluster and gets misapplied often. Introduced in 2024, it captures the practice expense of a pelvic exam performed alongside an eligible office visit, consult, or preventive code: staff time, a speculum, and supply costs, distinct from the physician's own work. A chaperone's presence is typical documentation for this code, though the code's own language doesn't require one. A primary code from a specific list is required instead, and G0101 or Q0091 don't qualify, since those two HCPCS codes already build practice expense into their own valuation.

Confirming which of these OB/GYN CPT codes fits a patient's age and payer, before the claim goes out rather than after a denial arrives, is exactly the kind of check a coding review is built to run. Read the full 99396 age and modifier rules or the 18 to 39 preventive bracket.

Common Gynecologic Procedure CPT Codes

This next set of OB/GYN CPT codes covers table stakes territory, the procedures every GYN practice bills weekly. Colposcopy splits into four codes based on exactly what accompanies the exam. CPT 57452 covers the exam alone, with no tissue taken. CPT 57454 adds both a cervical biopsy and endocervical curettage. CPT 57455 adds a cervical biopsy only, with no curettage. CPT 57456 adds curettage only, with no biopsy. Mixing these up is one of the fastest ways to undercode or overcode a routine colposcopy visit.

CPT 58100 covers an endometrial biopsy. CPT 58120 covers dilation and curettage for a non-obstetric indication, a code worth keeping separate in your own mind from the pregnancy-loss codes covered earlier in this guide, since payers treat them as different clinical events. CPT 58558 covers hysteroscopy with biopsy or polypectomy. CPT 58300 and 58301 cover IUD insertion and removal.

Hysterectomy coding depends on surgical approach. CPT 58150 covers a total abdominal hysterectomy. The 58260 range covers a vaginal approach. The 58570 range covers a laparoscopic approach, and uterine weight above or below 250 grams changes which specific code in that range applies. The AMA maintains the full code set behind every number in this section at its own CPT code resources.

The single most common denial in this category comes from billing a colposcopy and an E/M visit on the same date without documenting a distinct, separately identifiable reason for that E/M. Payers bundle the two automatically when that documentation is missing.

OB/GYN Billing Modifiers That Actually Matter

Modifiers don't get their own code number, but they change how every one of the OB/GYN CPT codes above gets paid.

Modifier 59 and its more specific X modifier alternatives, XE, XS, XP, and XU, flag two services that would normally bundle as separate and distinct. CMS lays out the underlying bundling logic in its own National Correct Coding Initiative Policy Manual. Payers prefer the specific X modifier over the general 59 whenever one applies. Read the full X modifier rules. Modifier 22 needs an operative report attached every time. The modifier alone, without that report, tells a payer nothing about why the case took more work than usual.

Modifier 24 covers care unrelated to a delivery or surgery during that procedure's global period, and it belongs on the E/M code, not the original procedure code. See the full global period rules. Getting this backward is a common, avoidable source of denied postpartum visits.

Where OB/GYN Claims Actually Get Denied

Most denials on OB/GYN CPT codes trace back to four repeat scenarios, not forty different problems. A global OB code gets billed when the patient transferred practices mid-pregnancy, and the claim doesn't match the tax ID or visit history the payer already has on file. A same-day E/M and preventive visit go out without modifier 25, and the system bundles them without a manual review. A colposcopy and biopsy get billed together with no documentation showing the biopsy came from a distinct site or session. An antepartum E/M claim goes out during the current transition period without modifier TH attached, a denial pattern that's brand new to this specific window.

Each one traces back to a single missing piece of documentation. That distinction matters, because it changes the fix. A coding error needs a new code. A documentation gap needs a different chart note next time. See a bundling denial worked through in detail.

A root-cause denial review works through exactly this kind of pattern: categorizing the denial, fixing the claim in front of you, and correcting the workflow that produced it so the same denial stops recurring on next month's report. See how root-cause denial review works.

What to Look for in an OB/GYN Billing and Credentialing Partner

Everything above in this guide is something your own billing team can learn and apply. Whether they have the time to apply it across every claim, every payer, and every code update is a separate question.

Four things separate a specialty billing partner from a general one:

• Published, transparent pricing, instead of a quote you request and wait for
• Coders who already know global OB packages and modifier TH, not general medical billing knowledge applied to OB/GYN by default
• Fast credentialing, since a delayed enrollment blocks every claim behind it no matter how clean the coding is
• One team handling both billing and credentialing, instead of two vendors that don't talk to each other

MedSole RCM builds around those four points directly. Medical billing starts at 2.99% of collections. Most billing companies charge between 4% and 7%, and some add setup fees or per-claim charges on top of that rate. Credentialing runs $99 per insurance enrollment, handled by the same team and under the same rate structure as the billing itself.

When the coding questions in this guide start pointing toward a bigger workflow gap than one denied claim, that's the moment to look at who is handling the billing. See how MedSole handles OB/GYN billing.

OB/GYN CPT Codes: Frequently Asked Questions

What are the OB/GYN CPT codes for 2026?

The active code ranges run from 56405 through 59899 for procedures, plus the standard evaluation and management ranges for office visits. The newest addition billing teams need to know is add-on code 99459, which covers the practice expense of a pelvic exam performed alongside an eligible visit. Everything in this range stays in effect through December 31, 2026, before the maternity-specific restructure covered earlier in this guide takes over.

What are the changes in OB-GYN coding for 2027?

Thirty-five maternity codes change. The AMA deletes seventeen, adds twelve, and revises six. The global package splits into four separately billed phases: antepartum, labor management, delivery, and postpartum. Gynecologic procedure codes, including colposcopy, hysterectomy, and IUD management, stay exactly as they are. CMS is finalizing its own payment rates for these codes through the CY 2027 Physician Fee Schedule proposed rule, with a final rule expected in November 2026.

What does CPT code 59400 include?

CPT 59400 includes routine antepartum visits, uncomplicated labor management, the vaginal delivery itself, first or second degree laceration repair, and routine postpartum care, all under one payment to one provider or group. It excludes ultrasounds, amniocentesis, non-stress tests, external cephalic version, and care for a condition unrelated to the pregnancy.

What does CPT code 59409 include?

CPT 59409 covers the vaginal delivery only, billed by a provider who did not handle the antepartum care for that pregnancy. It stops there. A different provider or code covers the postpartum visit, unless the same provider bills 59410 instead, which folds postpartum care into the same claim.

What is the difference between CPT 76801 and 76815?

CPT 76801 is a complete transabdominal ultrasound performed before 14 weeks 0 days of pregnancy. CPT 76815 is a limited scan usable in any trimester, built to answer one narrow clinical question rather than complete the full standard survey. A first trimester scan that couldn't visualize every required element under 76801 gets billed as 76815 instead.

What is the CPT code for D&C?

The answer depends on the clinical picture. CPT 58120 covers a non-obstetric dilation and curettage, used for conditions like abnormal bleeding. CPT 59812 and CPT 59820 cover the same procedure performed for a pregnancy loss, split by whether tissue has already passed. Confusing these three codes is one of the most common billing errors in this specialty.

What is the difference between CPT codes 59812 and 59820?

CPT 59812 treats an incomplete abortion, where the miscarriage has already started and some tissue has passed, and it applies in any trimester. CPT 59820 treats a missed abortion, where the pregnancy has stopped developing but nothing has passed yet, and it's restricted to the first trimester alone.

What is the CPT code for a GYN office visit?

A GYN visit addressing a specific problem, such as pelvic pain or abnormal bleeding, uses the standard office visit codes: 99202 through 99205 for a new patient, 99212 through 99215 for an established one. An annual well-woman exam uses a different set of codes entirely, the age-banded preventive codes covered earlier in this guide. Mixing the two up is a frequent source of denials on both sides.

What are OB/GYN coding guidelines?

Two systems govern OB/GYN billing: CPT for procedures and visits, maintained by the American Medical Association, and ICD-10-CM for diagnoses, maintained by CMS and the CDC. ACOG works with the AMA's CPT Editorial Panel on maternity-specific updates, which is why ACOG's own guidance carries real weight on questions like the 2027 restructure and the current modifier TH transition.

What should an OB/GYN practice look for in a billing and credentialing partner?

Transparent pricing, specialty-specific coding knowledge, fast credentialing turnaround, and one team handling both functions instead of two separate vendors. MedSole RCM's own published rates sit below the industry range on both fronts: medical billing starts at 2.99% of collections, against a typical 4% to 7%, and credentialing runs $99 per insurance enrollment, against a typical $200 to $500 or more.

The Bottom Line on OB/GYN CPT Codes

2026 codes stay active through December 31 of this year. The 2027 restructure replaces the global maternity package, phase by phase. The modifier TH transition is already underway.

If your billing team is still confirming where the practice stands on any of this, that's worth a second set of eyes before the next denial shows up. See how MedSole supports OB/GYN practices.

Sources Referenced in This Guide

• AMA, CPT 2027 Maternity Care Services code changes and guidelines
• AMA, CPT 2027 maternity care coding primer webinar
• ACOG, obstetric coding guidance
• AMA, CPT code resources
• CMS, Medicare wellness visit coverage
• CMS, National Correct Coding Initiative Policy Manual
• CMS, CY 2027 Physician Fee Schedule proposed rule fact sheet