CPT 59425

Antepartum Care Only 4-6 Visits

CPT 59425 pays $574.83 in a non-facility setting and $391.79 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $504.89 in Arkansas to $687.24 in Alaska, a 36% spread.

National non-facility rate

$574.83

Office and other outpatient settings

Facility rate
$391.79

Hospital and ASC settings

Highest state
$687.24

Alaska

Lowest state
$504.89

Arkansas · 36% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $574.83
CPT 59425 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $574.83, national facility $391.79.
StateRate compared visuallyNon-facilityFacility
Alaska
$687.24$492.30
Florida
$646.14$462.49
New York
$641.69$437.49
District of Columbia
$640.00$424.38
Illinois
$635.50$458.64
New Jersey
$624.61$418.51
Connecticut
$614.15$417.02
Washington
$600.89$392.23
Massachusetts
$600.22$394.57
Maryland
$594.18$403.37
California
$594.03$377.45
Michigan
$590.55$418.68
Rhode Island
$579.65$390.57
Georgia
$578.82$404.21
Pennsylvania
$577.40$398.11
Colorado
$576.99$382.24
Puerto Rico
$576.35$391.30
Virgin Islands
$576.35$391.30
Hawaii
$576.33$368.21
West Virginia
$575.52$416.46
New Hampshire
$575.35$384.81
Montana
$574.68$391.64
New Mexico
$569.90$402.05
Oregon
$569.15$376.32
Texas
$567.25$387.05
Delaware
$565.73$384.89
Nevada
$562.63$379.41
Louisiana
$557.47$390.35
Arizona
$556.67$379.31
Wyoming
$555.46$372.43
Ohio
$554.56$387.45
Missouri
$553.92$385.95
Utah
$552.84$380.79
Virginia
$548.85$368.93
South Carolina
$545.43$376.30
Kentucky
$541.88$379.16
Maine
$536.34$361.45
Vermont
$535.64$354.43
Oklahoma
$532.56$369.11
North Carolina
$531.87$361.10
North Dakota
$530.59$347.55
Minnesota
$529.35$341.00
South Dakota
$525.37$342.34
Mississippi
$522.05$364.46
Indiana
$519.04$349.36
Tennessee
$518.52$352.14
Idaho
$516.39$348.00
Kansas
$514.86$349.40
Wisconsin
$513.21$337.86
Alabama
$512.53$352.37
Nebraska
$510.03$341.09
Iowa
$509.53$342.05
Arkansas
$504.89$347.66

Billed by 1 specialties

Commercial rates for 59425

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates