CPT 99463

1st Hosp/Birthing Center Nb Admit & Dschg Sm Dat

CPT 99463 pays $94.86 in a non-facility setting and $94.86 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $90.02 in Arkansas to $129.74 in Alaska, a 44% spread.

National non-facility rate

$94.86

Office and other outpatient settings

Facility rate
$94.86

Hospital and ASC settings

Highest state
$129.74

Alaska

Lowest state
$90.02

Arkansas · 44% 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 $94.86
CPT 99463 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $94.86, national facility $94.86.
StateRate compared visuallyNon-facilityFacility
Alaska
$129.74$129.74
District of Columbia
$102.64$102.64
New York
$102.03$102.03
New Jersey
$101.32$101.32
Florida
$99.03$99.03
California
$98.97$98.97
Washington
$98.90$98.90
Connecticut
$98.68$98.68
Massachusetts
$98.60$98.60
Illinois
$98.41$98.41
Maryland
$96.94$96.94
Rhode Island
$96.38$96.38
Colorado
$96.00$96.00
Hawaii
$95.68$95.68
Michigan
$95.45$95.45
Pennsylvania
$95.40$95.40
Oregon
$95.26$95.26
New Hampshire
$95.11$95.11
Puerto Rico
$95.01$95.01
Virgin Islands
$95.01$95.01
Georgia
$94.93$94.93
Montana
$94.85$94.85
Texas
$94.64$94.64
Delaware
$94.54$94.54
West Virginia
$94.19$94.19
Nevada
$94.15$94.15
New Mexico
$94.12$94.12
Wyoming
$93.73$93.73
Arizona
$93.63$93.63
Louisiana
$93.38$93.38
Utah
$93.25$93.25
Virginia
$93.25$93.25
Ohio
$93.21$93.21
Missouri
$93.20$93.20
South Carolina
$92.73$92.73
Vermont
$92.52$92.52
Maine
$92.37$92.37
Minnesota
$92.36$92.36
Kentucky
$92.34$92.34
North Dakota
$92.28$92.28
North Carolina
$91.99$91.99
South Dakota
$91.98$91.98
Oklahoma
$91.82$91.82
Indiana
$91.21$91.21
Tennessee
$91.09$91.09
Wisconsin
$91.04$91.04
Mississippi
$91.03$91.03
Idaho
$91.02$91.02
Kansas
$90.85$90.85
Nebraska
$90.67$90.67
Iowa
$90.59$90.59
Alabama
$90.55$90.55
Arkansas
$90.02$90.02

Billed by 2 specialties

Commercial rates for 99463

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

See negotiated rates