CPT code 99359: Prolonged service, additional 30 minutes2026 Medicare rate & RVUs in New York
CPT 99359 represents each additional 30 minutes of prolonged evaluation and management work performed without direct patient contact, beyond the service reported with 99358.
CMS doesn’t publish an office rate for 99359 in New York.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in New York
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Manhattan, NY | Unavailable | Unavailable |
| NYC suburbs and Long Island, NY | Unavailable | Unavailable |
| Poughkeepsie and northern NYC suburbs, NY | Unavailable | Unavailable |
| Queens, NY | Unavailable | Unavailable |
| Rest of New York | Unavailable | Unavailable |
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.
How the rate is built · 99359
RVUs × geographic indexes × conversion factor
Work0.75
0.75 RVUs× 1.000 GPCI
Practice expense0.37
0.37 RVUs× 1.000 GPCI
Malpractice0.05
0.05 RVUs× 1.000 GPCI
Adjusted RVUs
1.1700
Conversion factor
$33.4009
Medicare rate
$39.08
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 99359
The CMS indicators that decide how 99359 is paid alongside other services.
CMS payment indicators · 99359
Prolonged service, additional 30 minutes
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| 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. |
99359 compared with similar codes
Compare codes · National
5 codes, side by side
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.
99359 billing questions
How does 99359 differ from 99358?
99358 reports the initial non-face-to-face prolonged service; 99359 represents each additional 30 minutes. The codes describe prolonged work without direct patient contact.
Can 99359 be reported by itself?
No. It is an add-on to 99358, not a stand-alone service code.
What documentation supports a unit of 99359?
Document the non-face-to-face work performed and the time supporting each additional 30-minute unit. The record should make clear that the work concerns the patient's evaluation and management.
Can Medicare claims use 99359?
No. Medicare physician fee schedule status I means 99359 is not valid for Medicare reporting; Medicare uses a different code for the service.
Is 99359 the code for prolonged time with the patient?
No. It concerns prolonged evaluation and management work without direct patient contact. Codes such as 99417 describe prolonged office or outpatient E/M time with direct patient contact.
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.
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