CPT code 59020: Fetal stress test, contraction-induced monitoring2026 Medicare rate & RVUs in Puerto Rico
Reports antepartum fetal assessment that monitors the fetal heart rate response to uterine contractions, including contractions induced for the test.
In Puerto Rico, Medicare pays $73.21 for 59020 in the office.
Check a contract rate as a % of Medicare · 59020 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 59020 covers
An obstetric clinician uses fetal heart rate and uterine activity monitoring to assess how the fetus responds to contractions. Contractions may occur spontaneously or be induced for testing. The service is generally performed in an obstetric setting when fetal status needs assessment before labor; it is distinct from monitoring a fetus during labor. The record should identify the reason for testing and include the monitoring findings and interpretation.
Report one service for the fetal contraction stress test, supported by documentation that contractions and the fetal heart rate response were evaluated. CMS treats this as a diagnostic test: modifier 26 reports the professional interpretation, modifier TC reports the technical service, and no modifier reports the global service. The 0-day global period includes same-day preoperative and postoperative care. Modifier 50 is inappropriate for this single fetal test. Assistant-at-surgery payment requires documented medical necessity; co-surgeon and team-surgery payment are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How Puerto Rico compares for 59020
Across 109 of 109 payment localities, the office rate for 59020 runs from $63.38 in Arkansas to $92.15 in San Benito County, CA. Puerto Rico pays $73.21. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Puerto Rico · this page$73.21
- Los Angeles, CA · California$79.81+$6.60
- Washington, DC area · District of Columbia$82.71+$9.50
- Miami, FL · Florida$84.37+$11.16
- Chicago, IL · Illinois$81.41+$8.20
- Manhattan, NY · New York$85.21+$12.00
- Alaska · Alaska$83.58+$10.37
Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $64.42 | — |
| ArkansasArkansas | $63.38 | — |
| ArizonaArizona | $70.50 | — |
| Bakersfield, CACalifornia | $75.07 | — |
| Chico, CACalifornia | $74.56 | — |
| El Centro, CACalifornia | $74.59 | — |
| Fresno, CACalifornia | $74.56 | — |
| Hanford, CACalifornia | $74.56 | — |
| Madera, CACalifornia | $74.56 | — |
| Merced, CACalifornia | $74.56 | — |
| Modesto, CACalifornia | $74.56 | — |
| Napa, CACalifornia | $85.38 | — |
| Oxnard, CACalifornia | $79.23 | — |
| Redding, CACalifornia | $74.56 | — |
| Rest of CaliforniaCalifornia | $74.56 | — |
| Riverside, CACalifornia | $76.59 | — |
| Sacramento, CACalifornia | $77.99 | — |
| Salinas, CACalifornia | $77.70 | — |
| San Diego, CACalifornia | $79.39 | — |
| Marin County, CACalifornia | $89.90 | — |
| San Francisco, CACalifornia | $89.68 | — |
| San Benito County, CACalifornia | $92.15 | — |
| Santa Clara County, CACalifornia | $91.27 | — |
| San Luis Obispo, CACalifornia | $76.50 | — |
| Santa Cruz, CACalifornia | $80.01 | — |
| Santa Maria, CACalifornia | $77.95 | — |
| Santa Rosa, CACalifornia | $80.79 | — |
| Stockton, CACalifornia | $74.56 | — |
| Vallejo, CACalifornia | $85.07 | — |
| Visalia, CACalifornia | $74.56 | — |
| Yuba City, CACalifornia | $74.56 | — |
| ColoradoColorado | $74.57 | — |
| ConnecticutConnecticut | $78.05 | — |
| DelawareDelaware | $71.74 | — |
| Fort Lauderdale, FLFlorida | $78.53 | — |
| Rest of FloridaFlorida | $74.02 | — |
| Atlanta, GAGeorgia | $74.88 | — |
| Rest of GeorgiaGeorgia | $69.16 | — |
| Hawaii, Guam, HIHawaii | $76.32 | — |
| IowaIowa | $65.15 | — |
| IdahoIdaho | $65.86 | — |
| East St. Louis, ILIllinois | $75.64 | — |
| Rest of IllinoisIllinois | $72.46 | — |
| Suburban Chicago, ILIllinois | $79.08 | — |
| IndianaIndiana | $66.26 | — |
| KansasKansas | $65.34 | — |
| KentuckyKentucky | $67.27 | — |
| New Orleans, LALouisiana | $71.02 | — |
| Rest of LouisianaLouisiana | $67.36 | — |
| Metropolitan Boston, MAMassachusetts | $81.74 | — |
| Rest of MassachusettsMassachusetts | $74.26 | — |
| Baltimore area, MDMaryland | $77.95 | — |
| Rest of MarylandMaryland | $73.05 | — |
| Rest of MaineMaine | $66.81 | — |
| Southern Maine, MEMaine | $70.07 | — |
| Detroit, MIMichigan | $75.59 | — |
| Rest of MichiganMichigan | $69.71 | — |
| MinnesotaMinnesota | $69.65 | — |
| Metropolitan Kansas City, MOMissouri | $69.92 | — |
| Metropolitan St. Louis, MOMissouri | $70.66 | — |
| Rest of MissouriMissouri | $66.43 | — |
| MississippiMississippi | $64.89 | — |
| MontanaMontana | $72.80 | — |
| North CarolinaNorth Carolina | $67.50 | — |
| North DakotaNorth Dakota | $69.04 | — |
| NebraskaNebraska | $65.39 | — |
| New HampshireNew Hampshire | $73.87 | — |
| Northern New JerseyNew Jersey | $81.81 | — |
| Rest of New JerseyNew Jersey | $78.43 | — |
| New MexicoNew Mexico | $70.35 | — |
| NevadaNevada | $71.80 | — |
| NYC suburbs and Long Island, NYNew York | $88.14 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $79.39 | — |
| Queens, NYNew York | $85.19 | — |
| Rest of New YorkNew York | $68.67 | — |
| OhioOhio | $68.94 | — |
| OklahomaOklahoma | $66.57 | — |
| Portland, OROregon | $76.54 | — |
| Rest of OregonOregon | $70.75 | — |
| Metropolitan Philadelphia, PAPennsylvania | $76.27 | — |
| Rest of PennsylvaniaPennsylvania | $68.77 | — |
| Rhode IslandRhode Island | $74.02 | — |
| South CarolinaSouth Carolina | $68.44 | — |
| South DakotaSouth Dakota | $68.60 | — |
| TennesseeTennessee | $65.77 | — |
| Austin, TXTexas | $74.75 | — |
| Beaumont, TXTexas | $68.31 | — |
| Brazoria, TXTexas | $71.18 | — |
| Dallas, TXTexas | $71.92 | — |
| Fort Worth, TXTexas | $71.56 | — |
| Galveston, TXTexas | $71.58 | — |
| Houston, TXTexas | $75.06 | — |
| Rest of TexasTexas | $69.90 | — |
| UtahUtah | $69.46 | — |
| VirginiaVirginia | $70.18 | — |
| Virgin Islands, VIUnited States Virgin Islands | $73.21 | — |
| VermontVermont | $69.23 | — |
| Rest of WashingtonWashington | $73.96 | — |
| King County, WAWashington | $82.96 | — |
| WisconsinWisconsin | $66.53 | — |
| West VirginiaWest Virginia | $69.64 | — |
| WyomingWyoming | $71.16 | — |
59020 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$63.38
$83.58
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $83.58 | 1 |
| AL | $64.42 | 1 |
| AR | $63.38 | 1 |
| AZ | $70.50 | 1 |
| CA | $74.56–$92.15 | 29 |
| CO | $74.57 | 1 |
| CT | $78.05 | 1 |
| DC | $82.71 | 1 |
| DE | $71.74 | 1 |
| FL | $74.02–$84.37 | 3 |
| GA | $69.16–$74.88 | 2 |
| GU | $76.32 | 1 |
| HI | $76.32 | 1 |
| IA | $65.15 | 1 |
| ID | $65.86 | 1 |
| IL | $72.46–$81.41 | 4 |
| IN | $66.26 | 1 |
| KS | $65.34 | 1 |
| KY | $67.27 | 1 |
| LA | $67.36–$71.02 | 2 |
| MA | $74.26–$81.74 | 2 |
| MD | $73.05–$82.71 | 3 |
| ME | $66.81–$70.07 | 2 |
| MI | $69.71–$75.59 | 2 |
| MN | $69.65 | 1 |
| MO | $66.43–$70.66 | 3 |
| MS | $64.89 | 1 |
| MT | $72.80 | 1 |
| NC | $67.50 | 1 |
| ND | $69.04 | 1 |
| NE | $65.39 | 1 |
| NH | $73.87 | 1 |
| NJ | $78.43–$81.81 | 2 |
| NM | $70.35 | 1 |
| NV | $71.80 | 1 |
| NY | $68.67–$88.14 | 5 |
| OH | $68.94 | 1 |
| OK | $66.57 | 1 |
| OR | $70.75–$76.54 | 2 |
| PA | $68.77–$76.27 | 2 |
| PR | $73.21 | 1 |
| RI | $74.02 | 1 |
| SC | $68.44 | 1 |
| SD | $68.60 | 1 |
| TN | $65.77 | 1 |
| TX | $68.31–$75.06 | 8 |
| UT | $69.46 | 1 |
| VA | $70.18–$82.71 | 2 |
| VI | $73.21 | 1 |
| VT | $69.23 | 1 |
| WA | $73.96–$82.96 | 2 |
| WI | $66.53 | 1 |
| WV | $69.64 | 1 |
| WY | $71.16 | 1 |
How the 59020 rate is calculated
Each of 59020’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 59020
RVUs × geographic indexes × conversion factor
Work0.64
0.64 RVUs× 1.000 GPCI
Practice expense1.35
1.35 RVUs× 1.000 GPCI
Malpractice0.19
0.19 RVUs× 1.000 GPCI
Adjusted RVUs
2.1800
Conversion factor
$33.4009
Medicare rate
$72.81
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Puerto Rico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
6,628
- Code
- 59020
- Physician work
- 0.64
- Practice expense
- 1.35
- Malpractice
- 0.19
GPCI2026.csv
91
- Locality
- Puerto Rico
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.64 | × 1.000 | 0.6400 |
| Practice expense | 1.35 | × 1.011 | 1.3648 |
| Malpractice | 0.19 | × 0.985 | 0.1872 |
| Total RVUs | 2.1920 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Puerto Rico$73.21
Office: (0.64 × 1 + 1.35 × 1.011 + 0.19 × 0.985) × $33.4009 = $73.21
Payment rules and modifiers for 59020
The CMS indicators that decide how 59020 is paid alongside other services.
CMS payment indicators · 59020
Fetal stress test, contraction-induced monitoring
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
59020 without 26 · national office
$72.81
Fetal stress test, contraction-induced monitoring
59020-26 · Professional component
$36.74
Pays only the interpretation and report.
How 59020 has changed in Puerto Rico
59020 · Office / nonfacility
$73.21
Effective 2026-10-01
The base rate is $4.12 higher than on 2025-10-01, moving from $69.09 to $73.21 (6.0%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$69.09changed to$73.21
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.66 changed to 0.64
- Practice expense RVU 1.29 changed to 1.35
- Malpractice RVU 0.18 changed to 0.19
- Practice expense GPCI 1.007 changed to 1.011
- Malpractice GPCI 0.982 changed to 0.985
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$71.76changed to$69.09
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 1.30 changed to 1.29
- Malpractice RVU 0.19 changed to 0.18
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$70.59changed to$71.76
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$71.74changed to$70.59
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 1.26 changed to 1.30
- Practice expense GPCI 1.008 changed to 1.007
- Malpractice GPCI 0.984 changed to 0.982
October 1, 2023
RVU23D
$71.50changed to$71.74
- Practice expense GPCI 1.000 changed to 1.008
- Malpractice GPCI 1.000 changed to 0.984
January 1, 2023
RVU23A
$72.23changed to$71.50
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 1.23 changed to 1.26
- Practice expense GPCI 1.008 changed to 1.000
- Malpractice GPCI 0.986 changed to 1.000
Held through RVU23B, RVU23C.
January 1, 2022
RVU22A
$72.14changed to$72.23
- Conversion factor 34.8931 changed to 34.6062
- Malpractice RVU 0.17 changed to 0.19
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$72.44changed to$72.14
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 1.17 changed to 1.23
- Malpractice GPCI 0.988 changed to 0.986
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$71.96changed to$72.44
- Conversion factor 36.0391 changed to 36.0896
- Malpractice RVU 0.16 changed to 0.17
- Practice expense GPCI 1.007 changed to 1.008
- Malpractice GPCI 0.990 changed to 0.988
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$72.96changed to$71.96
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 1.20 changed to 1.17
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$64.55changed to$72.96
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 1.21 changed to 1.20
- Practice expense GPCI 0.856 changed to 1.007
- Malpractice GPCI 0.642 changed to 0.990
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$55.85changed to$64.55
- Conversion factor 35.8043 changed to 35.8887
- Practice expense GPCI 0.705 changed to 0.856
- Malpractice GPCI 0.293 changed to 0.642
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$56.16changed to$55.85
- Conversion factor 35.9335 changed to 35.8043
- Malpractice RVU 0.17 changed to 0.16
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$55.88changed to$56.16
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$54.70changed to$55.88
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 1.19 changed to 1.21
- Malpractice RVU 0.16 changed to 0.17
- Practice expense GPCI 0.692 changed to 0.705
- Malpractice GPCI 0.271 changed to 0.293
Held through RVU15B.
January 1, 2014
RVU14A
$54.34changed to$54.70
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 1.32 changed to 1.19
- Malpractice RVU 0.17 changed to 0.16
- Practice expense GPCI 0.678 changed to 0.692
- Malpractice GPCI 0.249 changed to 0.271
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $54.34
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $73.21 | Not available in this setting | RVU26D |
| 2026-07-01 | $73.21 | Not available in this setting | RVU26C |
| 2026-04-01 | $73.21 | Not available in this setting | RVU26B |
| 2026-01-01 | $73.21 | Not available in this setting | RVU26A |
| 2025-10-01 | $69.09 | Not available in this setting | RVU25D |
| 2025-07-01 | $69.09 | Not available in this setting | RVU25C |
| 2025-04-01 | $69.09 | Not available in this setting | RVU25B |
| 2025-01-01 | $69.09 | Not available in this setting | RVU25A |
| 2024-10-01 | $71.76 | Not available in this setting | RVU24D |
| 2024-07-01 | $71.76 | Not available in this setting | RVU24C |
| 2024-04-01 | $71.76 | Not available in this setting | RVU24B |
| 2024-03-09 | $71.76 | Not available in this setting | RVU24AR |
| 2024-01-01 | $70.59 | Not available in this setting | RVU24A |
| 2023-10-01 | $71.74 | Not available in this setting | RVU23D |
| 2023-07-01 | $71.50 | Not available in this setting | RVU23C |
| 2023-04-01 | $71.50 | Not available in this setting | RVU23B |
| 2023-01-01 | $71.50 | Not available in this setting | RVU23A |
| 2022-10-01 | $72.23 | Not available in this setting | RVU22D |
| 2022-07-01 | $72.23 | Not available in this setting | RVU22C |
| 2022-04-01 | $72.23 | Not available in this setting | RVU22B |
| 2022-01-01 | $72.23 | Not available in this setting | RVU22A |
| 2021-10-01 | $72.14 | Not available in this setting | RVU21D |
| 2021-07-01 | $72.14 | Not available in this setting | RVU21C |
| 2021-04-01 | $72.14 | Not available in this setting | RVU21B |
| 2021-01-01 | $72.14 | Not available in this setting | RVU21A |
| 2020-10-01 | $72.44 | Not available in this setting | RVU20D |
| 2020-07-01 | $72.44 | Not available in this setting | RVU20C |
| 2020-04-01 | $72.44 | Not available in this setting | RVU20B |
| 2020-01-01 | $72.44 | Not available in this setting | RVU20A |
| 2019-10-01 | $71.96 | Not available in this setting | RVU19D |
| 2019-07-01 | $71.96 | Not available in this setting | RVU19C |
| 2019-04-01 | $71.96 | Not available in this setting | RVU19B |
| 2019-01-01 | $71.96 | Not available in this setting | RVU19A |
| 2018-10-01 | $72.96 | Not available in this setting | RVU18D |
| 2018-07-01 | $72.96 | Not available in this setting | RVU18C |
| 2018-04-01 | $72.96 | Not available in this setting | RVU18B |
| 2018-01-01 | $72.96 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $64.55 | Not available in this setting | RVU17D |
| 2017-07-01 | $64.55 | Not available in this setting | RVU17C |
| 2017-04-01 | $64.55 | Not available in this setting | RVU17B |
| 2017-01-01 | $64.55 | Not available in this setting | RVU17A |
| 2016-10-01 | $55.85 | Not available in this setting | RVU16D |
| 2016-07-01 | $55.85 | Not available in this setting | RVU16C |
| 2016-04-01 | $55.85 | Not available in this setting | RVU16B |
| 2016-01-01 | $55.85 | Not available in this setting | RVU16A |
| 2015-10-01 | $56.16 | Not available in this setting | RVU15D |
| 2015-07-01 | $56.16 | Not available in this setting | RVU15C |
| 2015-04-01 | $55.88 | Not available in this setting | RVU15B |
| 2015-01-01 | $55.88 | Not available in this setting | RVU15A |
| 2014-10-01 | $54.70 | Not available in this setting | RVU14D |
| 2014-07-01 | $54.70 | Not available in this setting | RVU14C |
| 2014-04-01 | $54.70 | Not available in this setting | RVU14B |
| 2014-01-01 | $54.70 | Not available in this setting | RVU14A |
| 2013-10-01 | $54.34 | Not available in this setting | RVU13D |
| 2013-07-01 | $54.34 | Not available in this setting | RVU13C |
| 2013-04-01 | $54.34 | Not available in this setting | RVU13B |
| 2013-01-01 | $54.34 | Not available in this setting | RVU13AR |
Where the Puerto Rico rate applies
Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.
- Aceitunas
- Adjuntas
- Aguada
- Aguadilla
- Aguas Buenas
- Aguas Claras
- Aguilita
- Aibonito
59020 billing questions
How does this differ from 59025?
Code 59020 is for assessing the fetal heart rate response to uterine contractions. Code 59025 is a non-stress test, which monitors fetal heart rate without contraction stress.
Can the professional and technical services be billed separately?
Yes. Use modifier 26 for the professional interpretation or TC for the technical service. Billing without either modifier represents the global service.
What documentation supports reporting 59020?
Document the indication, the contraction activity evaluated, the fetal heart rate response, and the interpretation. The record should support that a contraction stress test was performed rather than a non-stress test.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this single fetal test.
What care is included in the global service?
The 0-day global period includes same-day preoperative and postoperative care. It does not create a multi-day global package.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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