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

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 RVU26DEffective Oct 1, 2026One payment locality

CMS doesn’t publish a rate for 99359 in Puerto Rico.

Separate payment rules applyOffice (non-facility)
Separate payment rules applyHospital or facility

Check a contract rate as a % of Medicare · 99359 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 99359 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 99359 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 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.

How Puerto Rico compares for 99359

99359 in Puerto Rico vs other payment areas
  1. Puerto Rico · this pageUnavailable
  2. Los Angeles, CA · CaliforniaUnavailable
  3. Washington, DC area · District of ColumbiaUnavailable
  4. Miami, FL · FloridaUnavailable
  5. Chicago, IL · IllinoisUnavailable
  6. Manhattan, NY · New YorkUnavailable
  7. Alaska · AlaskaUnavailable

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

Every other payment area

99359 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama——
ArkansasArkansas——
ArizonaArizona——
Bakersfield, CACalifornia——
Chico, CACalifornia——
El Centro, CACalifornia——
Fresno, CACalifornia——
Hanford, CACalifornia——

99359 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.

View every state and territory as a table
99359 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 99359 in every payment locality

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

Office or facility?

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

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

Codes related to 99359

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

Codes related to 99359
CodeHow it relatesOffice range, Puerto Rico
Primary code
99358Prolonged E/M, without direct contact99359 reports additional non-face-to-face prolonged time with this base code.No office rate
Used instead
99417Prolonged E/M, office or outpatientReports prolonged office or outpatient E/M time with direct patient contact, rather than non-face-to-face work.No office rate
G2212Prolonged office visit, medicare add-on, each 15 minutesMedicare prolonged office or outpatient E/M code for qualifying direct-contact time.$34.18

How 99359 has changed in Puerto Rico

99359 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

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, 2023

    RVU23A

    $54.07changed toNo rate

    Held through RVU23B, RVU23C, RVU23D, RVU24A, RVU24AR, RVU24B, RVU24C, RVU24D, RVU25A, RVU25B, RVU25C, RVU25D, RVU26A, RVU26B, RVU26C, RVU26D.

  2. January 1, 2022

    RVU22A

    $53.49changed to$54.07

    • Conversion factor 34.8931 changed to 34.6062
    • Malpractice RVU 0.06 changed to 0.09

    Held through RVU22B, RVU22C, RVU22D.

  3. January 1, 2021

    RVU21A

    $55.68changed to$53.49

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.46 changed to 0.47
    • Malpractice RVU 0.08 changed to 0.06
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  4. January 1, 2020

    RVU20A

    $54.87changed to$55.68

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.45 changed to 0.46
    • Malpractice RVU 0.07 changed to 0.08
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  5. January 1, 2019

    RVU19A

    $54.81changed to$54.87

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  6. January 1, 2018

    RVU18AR1

    $51.33changed to$54.81

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  7. January 1, 2017

    RVU17A

    No ratechanged to$51.33

    Held through RVU17B, RVU17C, RVU17D.

  8. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Separate payment rules applySeparate payment rules applyRVU26D
2026-07-01Separate payment rules applySeparate payment rules applyRVU26C
2026-04-01Separate payment rules applySeparate payment rules applyRVU26B
2026-01-01Separate payment rules applySeparate payment rules applyRVU26A
2025-10-01Separate payment rules applySeparate payment rules applyRVU25D
2025-07-01Separate payment rules applySeparate payment rules applyRVU25C
2025-04-01Separate payment rules applySeparate payment rules applyRVU25B
2025-01-01Separate payment rules applySeparate payment rules applyRVU25A
2024-10-01Separate payment rules applySeparate payment rules applyRVU24D
2024-07-01Separate payment rules applySeparate payment rules applyRVU24C
2024-04-01Separate payment rules applySeparate payment rules applyRVU24B
2024-03-09Separate payment rules applySeparate payment rules applyRVU24AR
2024-01-01Separate payment rules applySeparate payment rules applyRVU24A
2023-10-01Separate payment rules applySeparate payment rules applyRVU23D
2023-07-01Separate payment rules applySeparate payment rules applyRVU23C
2023-04-01Separate payment rules applySeparate payment rules applyRVU23B
2023-01-01Separate payment rules applySeparate payment rules applyRVU23A
2022-10-01$54.07$54.07RVU22D
2022-07-01$54.07$54.07RVU22C
2022-04-01$54.07$54.07RVU22B
2022-01-01$54.07$54.07RVU22A
2021-10-01$53.49$53.49RVU21D
2021-07-01$53.49$53.49RVU21C
2021-04-01$53.49$53.49RVU21B
2021-01-01$53.49$53.49RVU21A
2020-10-01$55.68$55.68RVU20D
2020-07-01$55.68$55.68RVU20C
2020-04-01$55.68$55.68RVU20B
2020-01-01$55.68$55.68RVU20A
2019-10-01$54.87$54.87RVU19D
2019-07-01$54.87$54.87RVU19C
2019-04-01$54.87$54.87RVU19B
2019-01-01$54.87$54.87RVU19A
2018-10-01$54.81$54.81RVU18D
2018-07-01$54.81$54.81RVU18C
2018-04-01$54.81$54.81RVU18B
2018-01-01$54.81$54.81RVU18AR1
2017-10-01$51.33$51.33RVU17D
2017-07-01$51.33$51.33RVU17C
2017-04-01$51.33$51.33RVU17B
2017-01-01$51.33$51.33RVU17A
2016-10-01Separate payment rules applySeparate payment rules applyRVU16D
2016-07-01Separate payment rules applySeparate payment rules applyRVU16C
2016-04-01Separate payment rules applySeparate payment rules applyRVU16B
2016-01-01Separate payment rules applySeparate payment rules applyRVU16A
2015-10-01Separate payment rules applySeparate payment rules applyRVU15D
2015-07-01Separate payment rules applySeparate payment rules applyRVU15C
2015-04-01Separate payment rules applySeparate payment rules applyRVU15B
2015-01-01Separate payment rules applySeparate payment rules applyRVU15A
2014-10-01Separate payment rules applySeparate payment rules applyRVU14D
2014-07-01Separate payment rules applySeparate payment rules applyRVU14C
2014-04-01Separate payment rules applySeparate payment rules applyRVU14B
2014-01-01Separate payment rules applySeparate payment rules applyRVU14A
2013-10-01Separate payment rules applySeparate payment rules applyRVU13D
2013-07-01Separate payment rules applySeparate payment rules applyRVU13C
2013-04-01Separate payment rules applySeparate payment rules applyRVU13B
2013-01-01Separate payment rules applySeparate payment rules applyRVU13AR

Price 99359 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

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.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates

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