What the whole vaginal birth after C-section (VBAC) costs
Global obstetric care for a vaginal delivery after a prior cesarean (59610); 59612 delivery only. Every bill that usually comes with it, who sends it, and where each number comes from.
National Medicare amounts (payment-area and wage adjustments at 1.0). Facility: OPPS Addendum B, July 2026 (national unadjusted rate); local = rate × (0.6 × wage index + 0.4); ASC Addendum AA, July 2026 (national rate); local = rate × (0.5 × wage index + 0.5); device-intensive (J8) codes keep the device portion unadjusted; FY 2026 IPPS final rule CMS-1833-F, Table 5; standard amounts from Tables 1A-1E; local = weight × (labor × wage index + non-labor + capital × wage index^0.6848). Leaves out teaching (IME), safety-net (DSH) and outlier add-ons. Surgeon: CMS Physician Fee Schedule CY2026 (RVU26D). Anesthesia: CMS base units × the CY2026 anesthesia conversion factor, with an assumed case time. An educational estimate, not a quote.
Line by line (hospital stay)
Hospital stay, MS-DRG 807: $4,906. Billed by The hospital. CMS FY2026 IPPS: MS-DRG 807 weight 0.6742; FY 2026 IPPS final rule CMS-1833-F, Table 5; standard amounts from Tables 1A-1E; local = weight × (labor × wage index + non-labor + capital × wage index^0.6848). Leaves out teaching (IME), safety-net (DSH) and outlier add-ons.
Surgeon, CPT 59610: $2,331. Billed by The surgeon's group. CMS Physician Fee Schedule CY2026 (RVU26D, Oct 2026 release), facility rate, PFS locality national (GPCI 1.0)
Anesthesia, ASA code 01967: $191. Billed by The anesthesia group. CMS anesthesia base units (CY2022 file, unchanged for CY2026) + CY2026 anesthesia conversion factor $20.49754 for the nation (ANES2026, RVU26D). Code mapping is ours, from the ASA code descriptors.
Consultation visit (new patient): $177. Billed by The surgeon's group. CMS PFS CY2026 (RVU26D), non-facility (office) rate, CPT 99204
Blood count (CBC): $8. Billed by The lab. CMS Clinical Laboratory Fee Schedule CY2026 Q4 (26CLABQ4), national limit
Basic metabolic panel: $8. Billed by The lab. CMS Clinical Laboratory Fee Schedule CY2026 Q4 (26CLABQ4), national limit
Pre-op ECG: $15. Billed by Office or hospital. CMS PFS CY2026 (RVU26D), non-facility (office) rate, CPT 93000
Questions
How much does a vaginal birth after C-section (VBAC) cost in total, with every bill?
At national Medicare rates for 2026, the whole vaginal birth after C-section (VBAC) comes to about $7,636 in a hospital stay, counting the facility, the surgeon, anesthesia and typical care before and after. Commercial plans usually pay more; local rates differ by area.
Why do I get separate bills for a vaginal birth after C-section (VBAC)?
The hospital bills for the facility; the surgeon's group bills for the operation (Surgeon, CPT 59610, about $2,331 from Medicare nationally); the anesthesia group bills by base units plus time (about $191 at our default time); labs, imaging, pathology and therapy each come from their own provider.
What does the surgeon's fee include?
Maternity global: prenatal visits, the delivery and postpartum care are one fee.