CPT code 59426: Prenatal care, seven or more visits2026 Medicare rate & RVUs in South Dakota

In South Dakota, Medicare pays $964.54 for 59426 in the office and $627.52 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.

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 South 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. South Dakota pays $964.54. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

59426 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 59426 in every payment locality

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.

Payment rules and modifiers for 59426

The CMS indicators that decide how 59426 is paid alongside other services.

Codes related to 59426

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 59426 has changed in South Dakota

Price 59426 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

• Aberdeen
• Agar
• Agency Village
• Akaska
• Albee
• Alcester
• Alexandria
• Allen

Browse all communities in South Dakota

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

Open CMS sourceHow we calculate rates