CPT code 59430: Postpartum care2026 Medicare rate & RVUs in Washington
Reports postpartum-only care after childbirth when the practitioner provides recovery assessment and management without billing a maternity code that includes postpartum care.
Medicare pays $261.76–$288.85 for 59430 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
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.
Where 59430 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $261.76 | $156.95 |
| Seattle (King Cnty) | $288.85 | $166.72 |
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
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.
Payment rules and modifiers for 59430
The CMS indicators that decide how 59430 is paid alongside other services.
CMS payment indicators · 59430
Postpartum care
| Rule | CMS value | What it means |
|---|---|---|
| Global period | MMM | Maternity care: global rules don’t follow the standard pattern. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician 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
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%).
59430 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 59410Vaginal delivery
- Choose 59410 when the practitioner reports vaginal delivery and postpartum care together. Choose 59430 for postpartum care alone.
- 59400Maternity care
- 59400 covers antepartum care, vaginal delivery, and postpartum care. 59430 is limited to postpartum care.
- 59409Vaginal delivery
- 59409 reports vaginal delivery without postpartum care. 59430 reports postpartum care without the delivery service.
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
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