CPT code 59426: Prenatal care, seven or more visits2026 Medicare rate & RVUs in North Dakota
Report 59426 for a course of antepartum care involving seven or more prenatal visits when the billing clinician does not provide the full maternity package.
In North Dakota, Medicare pays $974.12 for 59426 in the office and $637.11 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 59426 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 59426 covers
CPT 59426 represents antepartum care furnished over seven or more prenatal visits, such as routine prenatal assessment, pregnancy monitoring, and counseling. Obstetricians, family physicians, and other clinicians providing maternity care may furnish these services in an office or clinic. The code covers the prenatal-care portion of the pregnancy; it does not include delivery or postpartum care. It may be relevant when care ends with a transfer before delivery or when another clinician handles the delivery and postpartum period.
Select 59426 based on the number of antepartum visits represented by the course of care: seven or more visits qualify, while four through six visits are reported with 59425. Keep documentation showing the dates and count of visits and the prenatal services furnished. Do not separately report the routine prenatal visits represented by this care package. CMS identifies this as a maternity service outside the usual global-surgery-period framework; it is not paid under the standard surgical global-period approach.
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 North Dakota compares for 59426
Across 109 of 109 payment localities, the office rate for 59426 runs from $926.88 in Arkansas to $1,286.73 in NYC suburbs and Long Island, NY. North Dakota pays $974.12. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Dakota · this page$974.12
- Los Angeles, CA · California$1,109.72+$135.60
- Washington, DC area · District of Columbia$1,175.21+$201.09
- Miami, FL · Florida$1,282.93+$308.81
- Chicago, IL · Illinois$1,238.36+$264.24
- Manhattan, NY · New York$1,237.71+$263.59
- Alaska · Alaska$1,261.46+$287.34
Other areas in North Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $940.92 | $646.04 |
| ArkansasArkansas | $926.88 | $637.39 |
| ArizonaArizona | $1,022.08 | $695.51 |
| Bakersfield, CACalifornia | $1,053.32 | $683.96 |
| Chico, CACalifornia | $1,042.37 | $673.00 |
| El Centro, CACalifornia | $1,043.06 | $673.69 |
| Fresno, CACalifornia | $1,042.37 | $673.00 |
| Hanford, CACalifornia | $1,042.37 | $673.00 |
| Madera, CACalifornia | $1,042.37 | $673.00 |
| Merced, CACalifornia | $1,042.37 | $673.00 |
| Modesto, CACalifornia | $1,042.37 | $673.00 |
| Napa, CACalifornia | $1,158.39 | $714.20 |
| Oxnard, CACalifornia | $1,097.46 | $699.10 |
| Redding, CACalifornia | $1,042.37 | $673.00 |
| Rest of CaliforniaCalifornia | $1,042.37 | $673.00 |
| Riverside, CACalifornia | $1,086.26 | $716.89 |
| Sacramento, CACalifornia | $1,080.99 | $689.04 |
| Salinas, CACalifornia | $1,076.83 | $686.23 |
| San Diego, CACalifornia | $1,093.49 | $690.42 |
| Marin County, CACalifornia | $1,207.52 | $732.33 |
| San Francisco, CACalifornia | $1,202.87 | $727.68 |
| San Benito County, CACalifornia | $1,239.34 | $753.36 |
| Santa Clara County, CACalifornia | $1,220.31 | $734.33 |
| San Luis Obispo, CACalifornia | $1,061.33 | $677.47 |
| Santa Cruz, CACalifornia | $1,096.75 | $687.28 |
| Santa Maria, CACalifornia | $1,078.49 | $685.53 |
| Santa Rosa, CACalifornia | $1,106.78 | $692.92 |
| Stockton, CACalifornia | $1,042.37 | $673.00 |
| Vallejo, CACalifornia | $1,151.68 | $707.49 |
| Visalia, CACalifornia | $1,042.37 | $673.00 |
| Yuba City, CACalifornia | $1,042.37 | $673.00 |
| ColoradoColorado | $1,059.43 | $700.84 |
| ConnecticutConnecticut | $1,127.73 | $764.76 |
| DelawareDelaware | $1,038.73 | $705.76 |
| Fort Lauderdale, FLFlorida | $1,171.85 | $830.45 |
| Rest of FloridaFlorida | $1,104.95 | $782.77 |
| Atlanta, GAGeorgia | $1,091.48 | $749.07 |
| Rest of GeorgiaGeorgia | $1,034.15 | $733.53 |
| Hawaii, Guam, HIHawaii | $1,058.22 | $675.03 |
| IowaIowa | $935.42 | $627.05 |
| IdahoIdaho | $948.03 | $637.97 |
| East St. Louis, ILIllinois | $1,159.06 | $849.00 |
| Rest of IllinoisIllinois | $1,094.21 | $786.52 |
| Suburban Chicago, ILIllinois | $1,176.44 | $830.32 |
| IndianaIndiana | $952.89 | $640.48 |
| KansasKansas | $945.22 | $640.56 |
| KentuckyKentucky | $994.89 | $695.28 |
| New Orleans, LALouisiana | $1,048.08 | $730.95 |
| Rest of LouisianaLouisiana | $999.01 | $700.76 |
| Metropolitan Boston, MAMassachusetts | $1,145.52 | $743.12 |
| Rest of MassachusettsMassachusetts | $1,058.68 | $703.80 |
| Baltimore area, MDMaryland | $1,127.75 | $766.13 |
| Rest of MarylandMaryland | $1,054.31 | $713.25 |
| Rest of MaineMaine | $968.43 | $658.38 |
| Southern Maine, MEMaine | $1,000.97 | $666.99 |
| Detroit, MIMichigan | $1,133.98 | $808.76 |
| Rest of MichiganMichigan | $1,034.78 | $727.08 |
| MinnesotaMinnesota | $971.85 | $625.06 |
| Metropolitan Kansas City, MOMissouri | $1,025.42 | $708.97 |
| Metropolitan St. Louis, MOMissouri | $1,034.58 | $713.74 |
| Rest of MissouriMissouri | $991.06 | $700.56 |
| MississippiMississippi | $958.44 | $668.27 |
| MontanaMontana | $1,055.19 | $718.18 |
| North CarolinaNorth Carolina | $976.49 | $662.06 |
| NebraskaNebraska | $936.34 | $625.28 |
| New HampshireNew Hampshire | $1,056.43 | $705.59 |
| Northern New JerseyNew Jersey | $1,165.41 | $774.48 |
| Rest of New JerseyNew Jersey | $1,128.42 | $760.40 |
| New MexicoNew Mexico | $1,046.40 | $737.36 |
| NevadaNevada | $1,033.04 | $695.69 |
| NYC suburbs and Long Island, NYNew York | $1,286.73 | $886.02 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $1,147.60 | $778.57 |
| Queens, NYNew York | $1,226.81 | $828.46 |
| Rest of New YorkNew York | $992.75 | $672.59 |
| OhioOhio | $1,018.21 | $710.51 |
| OklahomaOklahoma | $977.75 | $676.80 |
| Portland, OROregon | $1,076.99 | $702.57 |
| Rest of OregonOregon | $1,013.03 | $677.37 |
| Metropolitan Philadelphia, PAPennsylvania | $1,108.57 | $757.74 |
| Rest of PennsylvaniaPennsylvania | $1,011.78 | $702.40 |
| Puerto RicoPuerto Rico | $1,058.26 | $717.54 |
| Rhode IslandRhode Island | $1,064.30 | $716.17 |
| South CarolinaSouth Carolina | $1,001.42 | $690.02 |
| South DakotaSouth Dakota | $964.54 | $627.52 |
| TennesseeTennessee | $951.94 | $645.60 |
| Austin, TXTexas | $1,066.38 | $709.82 |
| Beaumont, TXTexas | $1,006.07 | $699.38 |
| Brazoria, TXTexas | $1,025.19 | $691.21 |
| Dallas, TXTexas | $1,038.56 | $702.89 |
| Fort Worth, TXTexas | $1,035.93 | $703.63 |
| Galveston, TXTexas | $1,032.65 | $697.99 |
| Houston, TXTexas | $1,107.69 | $773.04 |
| Rest of TexasTexas | $1,019.70 | $699.87 |
| UtahUtah | $1,015.05 | $698.25 |
| VirginiaVirginia | $1,007.71 | $676.43 |
| Virgin Islands, VIUnited States Virgin Islands | $1,058.26 | $717.54 |
| VermontVermont | $983.41 | $649.76 |
| Rest of WashingtonWashington | $1,052.32 | $697.44 |
| King County, WAWashington | $1,154.37 | $740.85 |
| WisconsinWisconsin | $942.19 | $619.33 |
| West VirginiaWest Virginia | $1,056.73 | $763.87 |
| WyomingWyoming | $1,019.86 | $682.85 |
59426 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.
$926.88
$1,261.46
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 | $1,261.46 | 1 |
| AL | $940.92 | 1 |
| AR | $926.88 | 1 |
| AZ | $1,022.08 | 1 |
| CA | $1,042.37–$1,239.34 | 29 |
| CO | $1,059.43 | 1 |
| CT | $1,127.73 | 1 |
| DC | $1,175.21 | 1 |
| DE | $1,038.73 | 1 |
| FL | $1,104.95–$1,282.93 | 3 |
| GA | $1,034.15–$1,091.48 | 2 |
| GU | $1,058.22 | 1 |
| HI | $1,058.22 | 1 |
| IA | $935.42 | 1 |
| ID | $948.03 | 1 |
| IL | $1,094.21–$1,238.36 | 4 |
| IN | $952.89 | 1 |
| KS | $945.22 | 1 |
| KY | $994.89 | 1 |
| LA | $999.01–$1,048.08 | 2 |
| MA | $1,058.68–$1,145.52 | 2 |
| MD | $1,054.31–$1,175.21 | 3 |
| ME | $968.43–$1,000.97 | 2 |
| MI | $1,034.78–$1,133.98 | 2 |
| MN | $971.85 | 1 |
| MO | $991.06–$1,034.58 | 3 |
| MS | $958.44 | 1 |
| MT | $1,055.19 | 1 |
| NC | $976.49 | 1 |
| ND | $974.12 | 1 |
| NE | $936.34 | 1 |
| NH | $1,056.43 | 1 |
| NJ | $1,128.42–$1,165.41 | 2 |
| NM | $1,046.40 | 1 |
| NV | $1,033.04 | 1 |
| NY | $992.75–$1,286.73 | 5 |
| OH | $1,018.21 | 1 |
| OK | $977.75 | 1 |
| OR | $1,013.03–$1,076.99 | 2 |
| PA | $1,011.78–$1,108.57 | 2 |
| PR | $1,058.26 | 1 |
| RI | $1,064.30 | 1 |
| SC | $1,001.42 | 1 |
| SD | $964.54 | 1 |
| TN | $951.94 | 1 |
| TX | $1,006.07–$1,107.69 | 8 |
| UT | $1,015.05 | 1 |
| VA | $1,007.71–$1,175.21 | 2 |
| VI | $1,058.26 | 1 |
| VT | $983.41 | 1 |
| WA | $1,052.32–$1,154.37 | 2 |
| WI | $942.19 | 1 |
| WV | $1,056.73 | 1 |
| WY | $1,019.86 | 1 |
How the 59426 rate is calculated
Each of 59426’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 · 59426
RVUs × geographic indexes × conversion factor
Work14.30
14.30 RVUs× 1.000 GPCI
Practice expense13.20
13.20 RVUs× 1.000 GPCI
Malpractice4.10
4.10 RVUs× 1.000 GPCI
Adjusted RVUs
31.6000
Conversion factor
$33.4009
Medicare rate
$1,055.47
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact North Dakota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
6,661
- Code
- 59426
- Physician work
- 14.30
- Practice expense
- 13.20
- Malpractice
- 4.10
GPCI2026.csv
84
- Locality
- North Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.406
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.30 | × 1.000 | 14.3000 |
| Practice expense | 13.20 | × 1.000 | 13.2000 |
| Malpractice | 4.10 | × 0.406 | 1.6646 |
| Total RVUs | 29.1646 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Dakota$974.12
Office: (14.3 × 1 + 13.2 × 1 + 4.1 × 0.406) × $33.4009 = $974.12
Facility: (14.3 × 1 + 3.11 × 1 + 4.1 × 0.406) × $33.4009 = $637.11
Payment rules and modifiers for 59426
The CMS indicators that decide how 59426 is paid alongside other services.
CMS payment indicators · 59426
Prenatal care, seven or more visits
| Rule | CMS value | What it means |
|---|---|---|
| Global period | MMM | Maternity care: global rules don’t follow the standard pattern. |
| 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 | 0 | Physician service: no professional/technical split. |
How 59426 has changed in North Dakota
59426 · Office / nonfacility
$974.12
Effective 2026-10-01
The base rate is $31.79 higher than on 2025-10-01, moving from $942.33 to $974.12 (3.4%).
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
$942.33changed to$974.12
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 12.78 changed to 13.20
- Malpractice RVU 3.97 changed to 4.10
- Malpractice GPCI 0.517 changed to 0.406
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$971.25changed to$942.33
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 12.82 changed to 12.78
- Malpractice RVU 3.98 changed to 3.97
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$955.40changed to$971.25
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$976.78changed to$955.40
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 12.69 changed to 12.82
- Malpractice RVU 3.87 changed to 3.98
- Malpractice GPCI 0.474 changed to 0.517
January 1, 2023
RVU23A
$979.17changed to$976.78
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 12.43 changed to 12.69
- Malpractice RVU 3.63 changed to 3.87
- Malpractice GPCI 0.431 changed to 0.474
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$975.96changed to$979.17
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 12.14 changed to 12.43
- Malpractice RVU 3.55 changed to 3.63
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$817.39changed to$975.96
- Conversion factor 36.0896 changed to 34.8931
- Work RVU 11.16 changed to 14.30
- Practice expense RVU 10.16 changed to 12.14
- Malpractice RVU 2.74 changed to 3.55
- Malpractice GPCI 0.485 changed to 0.431
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$806.03changed to$817.39
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 9.85 changed to 10.16
- Malpractice RVU 2.51 changed to 2.74
- Malpractice GPCI 0.540 changed to 0.485
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$796.64changed to$806.03
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 9.63 changed to 9.85
- Malpractice RVU 2.48 changed to 2.51
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$799.22changed to$796.64
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 9.72 changed to 9.63
- Malpractice RVU 2.54 changed to 2.48
- Malpractice GPCI 0.547 changed to 0.540
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$794.59changed to$799.22
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 9.62 changed to 9.72
- Malpractice RVU 2.55 changed to 2.54
- Malpractice GPCI 0.554 changed to 0.547
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$802.16changed to$794.59
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 9.64 changed to 9.62
- Malpractice RVU 2.75 changed to 2.55
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$798.17changed to$802.16
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$798.62changed to$798.17
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 9.59 changed to 9.64
- Malpractice RVU 2.88 changed to 2.75
- Malpractice GPCI 0.536 changed to 0.554
Held through RVU15B.
January 1, 2014
RVU14A
$790.56changed to$798.62
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 10.52 changed to 9.59
- Malpractice RVU 3.01 changed to 2.88
- Malpractice GPCI 0.517 changed to 0.536
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $790.56
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $974.12 | $637.11 | RVU26D |
| 2026-07-01 | $974.12 | $637.11 | RVU26C |
| 2026-04-01 | $974.12 | $637.11 | RVU26B |
| 2026-01-01 | $974.12 | $637.11 | RVU26A |
| 2025-10-01 | $942.33 | $711.38 | RVU25D |
| 2025-07-01 | $942.33 | $711.38 | RVU25C |
| 2025-04-01 | $942.33 | $711.38 | RVU25B |
| 2025-01-01 | $942.33 | $711.38 | RVU25A |
| 2024-10-01 | $971.25 | $731.91 | RVU24D |
| 2024-07-01 | $971.25 | $731.91 | RVU24C |
| 2024-04-01 | $971.25 | $731.91 | RVU24B |
| 2024-03-09 | $971.25 | $731.91 | RVU24AR |
| 2024-01-01 | $955.40 | $719.97 | RVU24A |
| 2023-10-01 | $976.78 | $738.89 | RVU23D |
| 2023-07-01 | $976.78 | $738.89 | RVU23C |
| 2023-04-01 | $976.78 | $738.89 | RVU23B |
| 2023-01-01 | $976.78 | $738.89 | RVU23A |
| 2022-10-01 | $979.17 | $741.77 | RVU22D |
| 2022-07-01 | $979.17 | $741.77 | RVU22C |
| 2022-04-01 | $979.17 | $741.77 | RVU22B |
| 2022-01-01 | $979.17 | $741.77 | RVU22A |
| 2021-10-01 | $975.96 | $748.46 | RVU21D |
| 2021-07-01 | $975.96 | $748.46 | RVU21C |
| 2021-04-01 | $975.96 | $748.46 | RVU21B |
| 2021-01-01 | $975.96 | $748.46 | RVU21A |
| 2020-10-01 | $817.39 | $606.27 | RVU20D |
| 2020-07-01 | $817.39 | $606.27 | RVU20C |
| 2020-04-01 | $817.39 | $606.27 | RVU20B |
| 2020-01-01 | $817.39 | $606.27 | RVU20A |
| 2019-10-01 | $806.03 | $606.73 | RVU19D |
| 2019-07-01 | $806.03 | $606.73 | RVU19C |
| 2019-04-01 | $806.03 | $606.73 | RVU19B |
| 2019-01-01 | $806.03 | $606.73 | RVU19A |
| 2018-10-01 | $796.64 | $608.00 | RVU18D |
| 2018-07-01 | $796.64 | $608.00 | RVU18C |
| 2018-04-01 | $796.64 | $608.00 | RVU18B |
| 2018-01-01 | $796.64 | $608.00 | RVU18AR1 |
| 2017-10-01 | $799.22 | $611.88 | RVU17D |
| 2017-07-01 | $799.22 | $611.88 | RVU17C |
| 2017-04-01 | $799.22 | $611.88 | RVU17B |
| 2017-01-01 | $799.22 | $611.88 | RVU17A |
| 2016-10-01 | $794.59 | $608.41 | RVU16D |
| 2016-07-01 | $794.59 | $608.41 | RVU16C |
| 2016-04-01 | $794.59 | $608.41 | RVU16B |
| 2016-01-01 | $794.59 | $608.41 | RVU16A |
| 2015-10-01 | $802.16 | $614.59 | RVU15D |
| 2015-07-01 | $802.16 | $614.59 | RVU15C |
| 2015-04-01 | $798.17 | $611.53 | RVU15B |
| 2015-01-01 | $798.17 | $611.53 | RVU15A |
| 2014-10-01 | $798.62 | $614.49 | RVU14D |
| 2014-07-01 | $798.62 | $614.49 | RVU14C |
| 2014-04-01 | $798.62 | $614.49 | RVU14B |
| 2014-01-01 | $798.62 | $614.49 | RVU14A |
| 2013-10-01 | $790.56 | $595.27 | RVU13D |
| 2013-07-01 | $790.56 | $595.27 | RVU13C |
| 2013-04-01 | $790.56 | $595.27 | RVU13B |
| 2013-01-01 | $790.56 | $595.27 | RVU13AR |
Where the North Dakota rate applies
North Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 406 cities and communities in North Dakota. Some span more than one payment area; confirm with the service ZIP.
- Abercrombie
- Adams
- Alamo
- Alexander
- Alice
- Almont
- Alsen
- Ambrose
59426 billing questions
How many visits qualify for 59426?
Use 59426 for seven or more antepartum visits. Four through six visits fall under 59425.
Does 59426 include delivery or postpartum care?
No. It represents antepartum care only; delivery and postpartum services are outside this code.
Can I also bill each prenatal visit separately?
Do not report the routine prenatal visits represented by the 59426 care package again as separate visit services.
What documentation supports 59426?
Record the dates and number of antepartum visits and the prenatal care furnished. The visit count distinguishes 59426 from 59425.
Does the usual surgical global period apply?
CMS treats 59426 as a maternity service outside the usual global-surgery-period framework.
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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