CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 59430 RVU and Medicare Payment (2026)
Care after delivery — 3.22 work RVU, about $261.2 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 3.22
- PE RVU (non-facility)
- 3.68
- PE RVU (facility)
- 0.7
- MP RVU
- 0.92
- Office payment
- $261.2
- Facility payment
- $161.66
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 59430 in a non-facility setting with national GPCI: (3.22 + 3.68 + 0.92) × $33.4009 ≈ $261.2. The same code in a facility setting pays about $161.66 because facility PE RVU (0.7) replaces office PE RVU.
What changes by locality
GPCI moves 59430 non-facility payment from $228.96 to $317.64 across CMS localities — from Arkansas to Nyc Suburbs/long Island. Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 59430?
3.22. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 59430 in 2026?
About $261.2 non-facility ($161.66 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (3.22) and malpractice RVU stay fixed; only practice expense changes (3.68 office vs 0.7 facility). That is the entire office-vs-facility payment gap.