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CPT code 59430: Postpartum care, postpartum phase only2026 Medicare rate & RVUs in Metropolitan Boston, MA

Reports postpartum-only care after childbirth when the practitioner provides recovery assessment and management without billing a maternity code that includes postpartum care.

CMS RVU26DEffective Oct 1, 2026One payment locality477 Medicare services in 2024

In Metropolitan Boston, MA, Medicare pays $286.07 for 59430 in the office and $167.23 when it’s performed in a hospital or facility.

$286.07Office (non-facility)
$167.23Hospital or facility
+9.5%vs the national office rate ($261.20)

Check a contract rate as a % of Medicare · 59430 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 59430 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Metropolitan Boston, MA
  2. What 59430 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 59430 covers

59430 represents the clinician’s postpartum-only care after childbirth, when that clinician is not billing a code that includes the delivery and postpartum period. An obstetrician/gynecologist or family physician commonly provides this care in an office or outpatient setting. The encounter may address recovery from vaginal or cesarean birth, maternal symptoms, healing, feeding concerns, mood, and contraception as part of postpartum management.

Report the code when the practitioner’s role is limited to the postpartum phase; it is not a delivery or antepartum-care code. Documentation should identify the postpartum assessment and management provided, along with relevant history or concerns addressed. The code represents postpartum care rather than each routine contact as a separate service. CMS classifies it as maternity care, so the usual surgical global-period rules do not govern it. If multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50% under the standard multiple-procedure reduction.

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 Metropolitan Boston, MA compares for 59430

Across 109 of 109 payment localities, the office rate for 59430 runs from $228.96 in Arkansas to $317.64 in NYC suburbs and Long Island, NY. Metropolitan Boston, MA pays $286.07. The RVUs are the same everywhere; the geographic indexes change the dollars.

59430 in Metropolitan Boston, MA vs other payment areas
  1. Metropolitan Boston, MA · this page$286.07
  2. Rest of Massachusetts · Massachusetts$263.19−$22.88
  3. Los Angeles, CA · California$277.77−$8.30
  4. Washington, DC area · District of Columbia$292.35+$6.28
  5. Miami, FL · Florida$313.22+$27.15
  6. Chicago, IL · Illinois$302.36+$16.29
  7. Manhattan, NY · New York$306.00+$19.93

Other areas in Massachusetts first, then benchmark localities. Bars start at $0.

Every other payment area

59430 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$309.16$203.16
AlabamaAlabama$232.49$145.40
ArkansasArkansas$228.96$143.46
ArizonaArizona$252.96$156.51
Bakersfield, CACalifornia$263.02$153.93
Chico, CACalifornia$260.57$151.48
El Centro, CACalifornia$260.72$151.63
Fresno, CACalifornia$260.57$151.48

59430 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$228.96

$309.16

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
59430 office rate range by state
State / territoryOffice rate rangeLocalities
AK$309.161
AL$232.491
AR$228.961
AZ$252.961
CA$260.57–$313.1029
CO$263.621
CT$279.261
DC$292.351
DE$257.151
FL$271.24–$313.223
GA$253.82–$269.662
GU$265.101
HI$265.101
IA$232.221
ID$235.171
IL$267.80–$302.364
IN$236.431
KS$234.151
KY$244.941
LA$245.77–$258.122
MA$263.19–$286.072
MD$261.23–$292.353
ME$239.75–$248.752
MI$254.47–$277.972
MN$243.131
MO$243.43–$255.363
MS$236.091
MT$261.131
NC$241.871
ND$242.941
NE$232.621
NH$262.391
NJ$279.79–$289.732
NM$257.171
NV$256.191
NY$245.92–$317.645
OH$250.751
OK$241.191
OR$251.58–$268.692
PA$249.43–$274.102
PR$262.091
RI$263.981
SC$247.241
SD$240.791
TN$235.781
TX$247.95–$272.758
UT$250.691
VA$250.07–$292.352
VI$262.091
VT$244.791
WA$261.76–$288.852
WI$234.771
WV$258.341
WY$253.211

See 59430 in every payment locality

How the 59430 rate is calculated

Each of 59430’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 · 59430

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.22

3.22 RVUs× 1.000 GPCI

Practice expense3.68

3.68 RVUs× 1.000 GPCI

Malpractice0.92

0.92 RVUs× 1.000 GPCI

Adjusted RVUs

7.8200

Conversion factor

$33.4009

Medicare rate

$261.20

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Metropolitan Boston, MA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,662

Code
59430
Physician work
3.22
Practice expense
3.68
Malpractice
0.92

GPCI2026.csv

62

Locality
Metropolitan Boston, MA
Physician work
1.041
Practice expense
1.194
Malpractice
0.890
Office calculation for 59430 in Metropolitan Boston, MA
ComponentRVULocality factorAdjusted
Physician work3.22× 1.0413.3520
Practice expense3.68× 1.1944.3939
Malpractice0.92× 0.8900.8188
Total RVUs8.5647
Conversion factor× 33.4009

Office rate, Metropolitan Boston, MA$286.07

Office: (3.22 × 1.041 + 3.68 × 1.194 + 0.92 × 0.89) × $33.4009 = $286.07

Facility: (3.22 × 1.041 + 0.7 × 1.194 + 0.92 × 0.89) × $33.4009 = $167.23

Open 59430 in the RVU calculator

Payment rules and modifiers for 59430

The CMS indicators that decide how 59430 is paid alongside other services.

CMS payment indicators · 59430

Postpartum care, postpartum phase only

RuleCMS valueWhat it means
Global periodMMMMaternity care: global rules don’t follow the standard pattern.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

59430 without 51 · national office

$261.20

Postpartum care, postpartum phase only

59430-51 · Second procedure: 50%

$130.60

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 59430

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

Codes related to 59430
CodeHow it relatesOffice range, Metropolitan Boston, MA
Used instead
59400Maternity care, antepartum, delivery, postpartumUse when the practitioner provides antepartum care, vaginal delivery, and postpartum care.No office rate
59410Vaginal delivery, postpartum care includedIncludes vaginal delivery plus postpartum care, unlike this postpartum-only service.No office rate
59409Vaginal delivery, delivery onlyCovers vaginal delivery without postpartum care when only the delivery service is reported.No office rate

How 59430 has changed in Metropolitan Boston, MA

59430 · Office / nonfacility

$286.07

Effective 2026-10-01

The base rate is $4.76 higher than on 2025-10-01, moving from $281.31 to $286.07 (1.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $281.31changed to$286.07

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 3.82 changed to 3.68
    • Malpractice RVU 0.86 changed to 0.92
    • Work GPCI 1.042 changed to 1.041
    • Practice expense GPCI 1.197 changed to 1.194
    • Malpractice GPCI 0.894 changed to 0.890

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $292.67changed to$281.31

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.87 changed to 3.82
    • Malpractice RVU 0.90 changed to 0.86

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $287.89changed to$292.67

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $297.58changed to$287.89

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.89 changed to 0.90
    • Work GPCI 1.045 changed to 1.042
    • Practice expense GPCI 1.200 changed to 1.197
    • Malpractice GPCI 0.868 changed to 0.894

  5. January 1, 2023

    RVU23A

    $301.52changed to$297.58

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.84 changed to 3.87
    • Malpractice RVU 0.85 changed to 0.89
    • Work GPCI 1.049 changed to 1.045
    • Practice expense GPCI 1.203 changed to 1.200
    • Malpractice GPCI 0.842 changed to 0.868

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $292.35changed to$301.52

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.59 changed to 3.84
    • Malpractice RVU 0.81 changed to 0.85

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $237.46changed to$292.35

    • Conversion factor 36.0896 changed to 34.8931
    • Work RVU 2.47 changed to 3.22
    • Practice expense RVU 2.87 changed to 3.59
    • Malpractice RVU 0.62 changed to 0.81
    • Work GPCI 1.041 changed to 1.049
    • Practice expense GPCI 1.191 changed to 1.203
    • Malpractice GPCI 0.952 changed to 0.842

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $221.33changed to$237.46

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.55 changed to 2.87
    • Malpractice RVU 0.55 changed to 0.62
    • Work GPCI 1.033 changed to 1.041
    • Practice expense GPCI 1.179 changed to 1.191
    • Malpractice GPCI 1.061 changed to 0.952

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $208.36changed to$221.33

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.25 changed to 2.55

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $203.42changed to$208.36

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.27 changed to 2.25
    • Malpractice RVU 0.57 changed to 0.55
    • Work GPCI 1.025 changed to 1.033
    • Practice expense GPCI 1.171 changed to 1.179
    • Malpractice GPCI 0.839 changed to 1.061

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $196.22changed to$203.42

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.25 changed to 2.27
    • Work GPCI 1.017 changed to 1.025
    • Practice expense GPCI 1.163 changed to 1.171
    • Malpractice GPCI 0.617 changed to 0.839

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $198.46changed to$196.22

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.26 changed to 2.25
    • Malpractice RVU 0.62 changed to 0.57

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $197.47changed to$198.46

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $198.39changed to$197.47

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.23 changed to 2.26
    • Malpractice RVU 0.64 changed to 0.62
    • Work GPCI 1.016 changed to 1.017
    • Practice expense GPCI 1.156 changed to 1.163
    • Malpractice GPCI 0.704 changed to 0.617

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$198.39

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$286.07$167.23RVU26D
2026-07-01$286.07$167.23RVU26C
2026-04-01$286.07$167.23RVU26B
2026-01-01$286.07$167.23RVU26A
2025-10-01$281.31$182.96RVU25D
2025-07-01$281.31$182.96RVU25C
2025-04-01$281.31$182.96RVU25B
2025-01-01$281.31$182.96RVU25A
2024-10-01$292.67$189.07RVU24D
2024-07-01$292.67$189.07RVU24C
2024-04-01$292.67$189.07RVU24B
2024-03-09$292.67$189.07RVU24AR
2024-01-01$287.89$185.99RVU24A
2023-10-01$297.58$191.85RVU23D
2023-07-01$297.58$191.85RVU23C
2023-04-01$297.58$191.85RVU23B
2023-01-01$297.58$191.85RVU23A
2022-10-01$301.52$193.70RVU22D
2022-07-01$301.52$193.70RVU22C
2022-04-01$301.52$193.70RVU22B
2022-01-01$301.52$193.70RVU22A
2021-10-01$292.35$194.55RVU21D
2021-07-01$292.35$194.55RVU21C
2021-04-01$292.35$194.55RVU21B
2021-01-01$292.35$194.55RVU21A
2020-10-01$237.46$155.36RVU20D
2020-07-01$237.46$155.36RVU20C
2020-04-01$237.46$155.36RVU20B
2020-01-01$237.46$155.36RVU20A
2019-10-01$221.33$153.35RVU19D
2019-07-01$221.33$153.35RVU19C
2019-04-01$221.33$153.35RVU19B
2019-01-01$221.33$153.35RVU19A
2018-10-01$208.36$153.61RVU18D
2018-07-01$208.36$153.61RVU18C
2018-04-01$208.36$153.61RVU18B
2018-01-01$208.36$153.61RVU18AR1
2017-10-01$203.42$149.63RVU17D
2017-07-01$203.42$149.63RVU17C
2017-04-01$203.42$149.63RVU17B
2017-01-01$203.42$149.63RVU17A
2016-10-01$196.22$143.34RVU16D
2016-07-01$196.22$143.34RVU16C
2016-04-01$196.22$143.34RVU16B
2016-01-01$196.22$143.34RVU16A
2015-10-01$198.46$144.97RVU15D
2015-07-01$198.46$144.97RVU15C
2015-04-01$197.47$144.24RVU15B
2015-01-01$197.47$144.24RVU15A
2014-10-01$198.39$146.62RVU14D
2014-07-01$198.39$146.62RVU14C
2014-04-01$198.39$146.62RVU14B
2014-01-01$198.39$146.62RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 59430 for an earlier date of service

Where the Metropolitan Boston, MA rate applies

Metropolitan Boston, MA is a Medicare payment area, not a city. Our Census mapping connects it to 60 cities and communities in Massachusetts. Some span more than one payment area; confirm with the service ZIP.

  • Boston
  • Arlington
  • Ayer
  • Bellingham
  • Belmont
  • Braintree Town
  • Brookline
  • Burlington

Browse all communities in Massachusetts

59430 billing questions

Is 59430 reported for each postpartum visit?

No. It represents postpartum care, not a separate code for each routine contact. Document the postpartum service and the assessment or management provided.

How does 59430 differ from 59410?

59430 is for postpartum care alone. 59410 includes vaginal delivery and postpartum care.

Can 59430 be reported with 59409?

59409 covers vaginal delivery without postpartum care. 59430 may describe separately provided postpartum care when another reported maternity code does not already include it.

What documentation supports 59430?

Document the postpartum assessment and management, the patient’s relevant recovery concerns, and the care provided during the postpartum phase.

Do the usual surgical global-period rules apply?

No. CMS identifies 59430 as a maternity code, for which the usual global surgery rules do not apply.

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
RVUs for 59430PPRRVU2026_Oct_nonQPP.csv, line 6,662 (RVU26D)
Geographic factors for Metropolitan Boston, MAGPCI2026.csv, line 62 (RVU26D)

Open CMS sourceHow we calculate rates

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