CPT code 59430: Postpartum care, postpartum phase only2026 Medicare rate & RVUs in Virginia

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 Virginia, Medicare pays $250.07 for 59430 in the office and $152.23 when it’s performed in a hospital or facility.

$250.07Office (non-facility)
$152.23Hospital or facility
−4.3%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 Virginia
  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 Virginia 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. Virginia pays $250.07. The RVUs are the same everywhere; the geographic indexes change the dollars.

59430 in Virginia vs other payment areas
  1. Virginia · this page$250.07
  2. Los Angeles, CA · California$277.77+$27.70
  3. Washington, DC area · District of Columbia$292.35+$42.28
  4. Miami, FL · Florida$313.22+$63.15
  5. Chicago, IL · Illinois$302.36+$52.29
  6. Manhattan, NY · New York$306.00+$55.93
  7. Alaska · Alaska$309.16+$59.09

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

Every other payment area

59430 in every other Medicare payment locality
Payment localityOfficeFacility
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
Hanford, CACalifornia$260.57$151.48

59430 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.

$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 Virginia 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

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 59430 in Virginia
ComponentRVULocality factorAdjusted
Physician work3.22× 1.0003.2200
Practice expense3.68× 0.9833.6174
Malpractice0.92× 0.7060.6495
Total RVUs7.4870
Conversion factor× 33.4009

Office rate, Virginia$250.07

Office: (3.22 × 1 + 3.68 × 0.983 + 0.92 × 0.706) × $33.4009 = $250.07

Facility: (3.22 × 1 + 0.7 × 0.983 + 0.92 × 0.706) × $33.4009 = $152.23

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

How 59430 has changed in Virginia

59430 · Office / nonfacility

$250.07

Effective 2026-10-01

The base rate is $3.12 higher than on 2025-10-01, moving from $246.95 to $250.07 (1.3%).

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

    $246.95changed to$250.07

    • 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 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $256.78changed to$246.95

    • 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

    $252.59changed to$256.78

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $263.86changed to$252.59

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.89 changed to 0.90
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755
  5. January 1, 2023

    RVU23A

    $270.04changed to$263.86

    • 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
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $262.35changed to$270.04

    • 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

    $211.99changed to$262.35

    • 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
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $197.63changed to$211.99

    • 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
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $186.76changed to$197.63

    • 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

    $186.61changed to$186.76

    • 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
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $184.44changed to$186.61

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.25 changed to 2.27
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $186.94changed to$184.44

    • 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

    $186.01changed to$186.94

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $184.61changed to$186.01

    • 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
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $182.47changed to$184.61

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.46 changed to 2.23
    • Malpractice RVU 0.67 changed to 0.64
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $182.47

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$250.07$152.23RVU26D
2026-07-01$250.07$152.23RVU26C
2026-04-01$250.07$152.23RVU26B
2026-01-01$250.07$152.23RVU26A
2025-10-01$246.95$166.11RVU25D
2025-07-01$246.95$166.11RVU25C
2025-04-01$246.95$166.11RVU25B
2025-01-01$246.95$166.11RVU25A
2024-10-01$256.78$171.62RVU24D
2024-07-01$256.78$171.62RVU24C
2024-04-01$256.78$171.62RVU24B
2024-03-09$256.78$171.62RVU24AR
2024-01-01$252.59$168.82RVU24A
2023-10-01$263.86$176.63RVU23D
2023-07-01$263.86$176.63RVU23C
2023-04-01$263.86$176.63RVU23B
2023-01-01$263.86$176.63RVU23A
2022-10-01$270.04$180.86RVU22D
2022-07-01$270.04$180.86RVU22C
2022-04-01$270.04$180.86RVU22B
2022-01-01$270.04$180.86RVU22A
2021-10-01$262.35$181.45RVU21D
2021-07-01$262.35$181.45RVU21C
2021-04-01$262.35$181.45RVU21B
2021-01-01$262.35$181.45RVU21A
2020-10-01$211.99$143.68RVU20D
2020-07-01$211.99$143.68RVU20C
2020-04-01$211.99$143.68RVU20B
2020-01-01$211.99$143.68RVU20A
2019-10-01$197.63$140.77RVU19D
2019-07-01$197.63$140.77RVU19C
2019-04-01$197.63$140.77RVU19B
2019-01-01$197.63$140.77RVU19A
2018-10-01$186.76$140.97RVU18D
2018-07-01$186.76$140.97RVU18C
2018-04-01$186.76$140.97RVU18B
2018-01-01$186.76$140.97RVU18AR1
2017-10-01$186.61$141.36RVU17D
2017-07-01$186.61$141.36RVU17C
2017-04-01$186.61$141.36RVU17B
2017-01-01$186.61$141.36RVU17A
2016-10-01$184.44$139.74RVU16D
2016-07-01$184.44$139.74RVU16C
2016-04-01$184.44$139.74RVU16B
2016-01-01$184.44$139.74RVU16A
2015-10-01$186.94$141.73RVU15D
2015-07-01$186.94$141.73RVU15C
2015-04-01$186.01$141.02RVU15B
2015-01-01$186.01$141.02RVU15A
2014-10-01$184.61$140.72RVU14D
2014-07-01$184.61$140.72RVU14C
2014-04-01$184.61$140.72RVU14B
2014-01-01$184.61$140.72RVU14A
2013-10-01$182.47$135.94RVU13D
2013-07-01$182.47$135.94RVU13C
2013-04-01$182.47$135.94RVU13B
2013-01-01$182.47$135.94RVU13AR

Price 59430 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

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 VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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