Codes, care, and consequence: A viewpoint on CPT valuation in obstetric practice

In 2027, obstetric care in the United States will be billed differently than it has been for nearly half a century. Long-standing maternity global codes will be retired and replaced by new and revised codes that separately report antepartum, labor management, delivery, and postpartum care. The valuation of these codes, and of the broader obstetric ultrasound family, is determined through the AMA/Specialty Society Relative Value Scale Update Committee (RUC) process and is constrained by statutory budget neutrality within the Medicare Physician Fee Schedule. This viewpoint argues that CPT valuation in obstetrics has consequences at the bedside and is supported by two arguments. First, valuation latency-the interval between a code's last survey and the current state of the work it describes-is itself a clinical problem, and the obstetric ultrasound family, in which expanding guideline content has outpaced formal revaluation, is the clearest current example. Second, the rigor of the specialty-society survey process is the proximate determinant of whether new and revised codes are valued accurately, and that rigor depends directly on the time and care physicians invest in their responses. The viewpoint is directed at maternal-fetal medicine and obstetric clinicians, providing background on the CPT valuation process and underscoring that thoughtful participation in specialty-society RUC surveys is a meaningful contribution to accurate valuation.