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CPT 59425 — Antepartum care only

CPT code 59425 (Antepartum care only) carries 7.8 work RVUs under the CMS 2026 Medicare Physician Fee Schedule. Total RVUs are 17.21 in a non-facility setting and 11.73 in a facility setting, which at the 2026 conversion factor of $33.40 works out to $574.83 and $391.79 respectively.

7.8
Work RVU
17.21
Total RVU (non-facility)
$574.83
Medicare, non-facility
$391.79
Medicare, facility
Calculate your total wRVUs →

RVU breakdown for CPT 59425

ComponentRVUsWhat it covers
Work RVU7.8Physician time, skill, effort, and stress.
Practice expense RVU (non-facility)7.18Office overhead, staff, supplies.
Practice expense RVU (facility)1.7Overhead when performed in a hospital.
Malpractice RVU2.23Professional liability cost.
Total RVU (non-facility)17.21Work + non-facility PE + malpractice.
Total RVU (facility)11.73Work + facility PE + malpractice.

How Medicare payment is calculated

Medicare multiplies total RVUs by the annual conversion factor. For CPT 59425 in 2026:

SettingTotal RVUConversion factorNational payment
Non-facility17.21$33.40$574.83
Facility11.73$33.40$391.79

These are national amounts. Actual payment is adjusted by the Geographic Practice Cost Index for your locality — check yours with the GPCI lookup.

Billing rules for CPT 59425

Global period
Maternity code — the usual global surgical package does not apply.
Multiple procedure reduction
No multiple-procedure payment reduction applies.
Bilateral surgery
Bilateral adjustment does not apply.
Assistant surgeon
Not permitted unless documentation supports medical necessity.
Co-surgeon
Not permitted unless documentation supports medical necessity.
Team surgery
Not permitted unless documentation supports medical necessity.

Related codes

Codes in the same CMS family, with their work RVU values.

59400 · 37.0 wRVU59409 · 14.37 wRVU59426 · 14.3 wRVU59430 · 3.22 wRVU

Questions about CPT 59425

How many work RVUs is CPT 59425?

CPT 59425 is assigned 7.8 work RVUs in the CMS 2026 Medicare Physician Fee Schedule.

What does Medicare pay for CPT 59425?

At the 2026 national conversion factor of $33.40, CPT 59425 pays approximately $574.83 in a non-facility setting and $391.79 in a facility setting before geographic adjustment.

What is the global period for CPT 59425?

Maternity code — the usual global surgical package does not apply.

RVU values reflect the CMS 2026 Medicare Physician Fee Schedule (conversion factor $33.40). Payment figures are national and unadjusted for geography. Verify against the official fee schedule before using for billing.