CPT code 99359: Prolonged service, additional 30 minutes2026 Medicare rate & RVUs

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

What 99359 covers

CPT 99359 is an add-on for extended evaluation and management work performed without direct patient contact. The work may involve reviewing extensive records, coordinating care, or communicating with other professionals about the patient. It represents additional time beyond the non-face-to-face prolonged service reported with 99358; it is not a stand-alone visit code.

For Medicare physician fee schedule purposes, status I means 99359 is not a valid Medicare reporting code and Medicare uses a different code to report and pay for the service. Do not submit 99359 as the Medicare code for this work. In CPT reporting, each unit represents an additional 30 minutes and is reported with 99358 when the documented prolonged work supports it.

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.

Where 99359 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

99359 rates by state

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

How the 99359 rate is calculated

Each of 99359’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 99359

The CMS indicators that decide how 99359 is paid alongside other services.

99359 compared with similar codes

How to choose

99358Prolonged E/MWithout direct contact

99358 reports the initial non-face-to-face prolonged service; 99359 is the add-on for each additional 30 minutes.

99417Prolonged E/MOffice or outpatient

99417 concerns prolonged office or outpatient E/M time with direct patient contact. CPT 99359 describes non-face-to-face prolonged E/M, but Medicare marks 99359 invalid and uses a different code for the service.

G2212Prolonged office visitMedicare add-on, each 15 minutes

G2212 is Medicare's prolonged office or outpatient E/M code for direct-contact time; 99359 describes additional non-face-to-face work and is not valid for Medicare reporting.

99360Physician standbyPer 30 minutes

99360 describes physician standby service, not extended record review, care coordination, or other non-face-to-face E/M work.

Codes related to 99359

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

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