CPT 99468

1st Inpatient Critical Care Pr Day Age 28 Days/<

CPT 99468 pays $778.57 in a non-facility setting and $778.57 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $742.64 in Arkansas to $1,077.82 in Alaska, a 45% spread.

National non-facility rate

$778.57

Office and other outpatient settings

Facility rate
$778.57

Hospital and ASC settings

Highest state
$1,077.82

Alaska

Lowest state
$742.64

Arkansas · 45% 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 $778.57
CPT 99468 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $778.57, national facility $778.57.
StateRate compared visuallyNon-facilityFacility
Alaska
$1,077.82$1,077.82
District of Columbia
$838.23$838.23
New York
$835.82$835.82
New Jersey
$829.08$829.08
Florida
$815.03$815.03
Illinois
$811.24$811.24
Connecticut
$808.44$808.44
Washington
$807.31$807.31
California
$805.95$805.95
Massachusetts
$805.49$805.49
Maryland
$794.81$794.81
Rhode Island
$790.27$790.27
Michigan
$786.53$786.53
Colorado
$785.57$785.57
Pennsylvania
$784.21$784.21
Georgia
$781.28$781.28
Oregon
$779.61$779.61
Hawaii
$779.52$779.52
Puerto Rico
$779.37$779.37
Virgin Islands
$779.37$779.37
New Hampshire
$778.90$778.90
West Virginia
$778.75$778.75
Montana
$778.50$778.50
Texas
$777.34$777.34
Delaware
$776.33$776.33
New Mexico
$775.94$775.94
Nevada
$772.34$772.34
Louisiana
$769.58$769.58
Arizona
$769.25$769.25
Wyoming
$768.67$768.67
Ohio
$768.10$768.10
Missouri
$767.78$767.78
Utah
$767.26$767.26
Virginia
$765.27$765.27
South Carolina
$763.45$763.45
Kentucky
$761.58$761.58
Maine
$758.84$758.84
Vermont
$758.53$758.53
Oklahoma
$756.82$756.82
North Carolina
$756.53$756.53
North Dakota
$755.96$755.96
Minnesota
$755.36$755.36
South Dakota
$753.29$753.29
Mississippi
$751.41$751.41
Indiana
$749.96$749.96
Tennessee
$749.67$749.67
Idaho
$748.59$748.59
Kansas
$747.79$747.79
Wisconsin
$747.02$747.02
Alabama
$746.56$746.56
Nebraska
$745.35$745.35
Iowa
$745.08$745.08
Arkansas
$742.64$742.64

Billed by 1 specialties

Commercial rates for 99468

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

See negotiated rates