CPT 99469

Subq I/P Critical Care Pr Day Age 28 Days/<

CPT 99469 pays $336.68 in a non-facility setting and $336.68 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $321.32 in Arkansas to $466.41 in Alaska, a 45% spread.

National non-facility rate

$336.68

Office and other outpatient settings

Facility rate
$336.68

Hospital and ASC settings

Highest state
$466.41

Alaska

Lowest state
$321.32

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 $336.68
CPT 99469 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $336.68, national facility $336.68.
StateRate compared visuallyNon-facilityFacility
Alaska
$466.41$466.41
District of Columbia
$362.48$362.48
New York
$361.31$361.31
New Jersey
$358.52$358.52
Florida
$352.04$352.04
Illinois
$350.41$350.41
Connecticut
$349.53$349.53
Washington
$349.23$349.23
California
$348.76$348.76
Massachusetts
$348.42$348.42
Maryland
$343.68$343.68
Rhode Island
$341.79$341.79
Michigan
$339.93$339.93
Colorado
$339.81$339.81
Pennsylvania
$339.09$339.09
Georgia
$337.76$337.76
Hawaii
$337.30$337.30
Oregon
$337.26$337.26
Puerto Rico
$337.03$337.03
Virgin Islands
$337.03$337.03
New Hampshire
$336.88$336.88
Montana
$336.65$336.65
West Virginia
$336.55$336.55
Texas
$336.18$336.18
Delaware
$335.75$335.75
New Mexico
$335.44$335.44
Nevada
$334.06$334.06
Louisiana
$332.76$332.76
Arizona
$332.71$332.71
Wyoming
$332.51$332.51
Ohio
$332.13$332.13
Missouri
$332.00$332.00
Utah
$331.82$331.82
Virginia
$331.05$331.05
South Carolina
$330.19$330.19
Kentucky
$329.35$329.35
Maine
$328.30$328.30
Vermont
$328.22$328.22
Oklahoma
$327.35$327.35
North Carolina
$327.29$327.29
North Dakota
$327.16$327.16
Minnesota
$326.95$326.95
South Dakota
$326.04$326.04
Mississippi
$325.02$325.02
Indiana
$324.51$324.51
Tennessee
$324.36$324.36
Idaho
$323.93$323.93
Kansas
$323.57$323.57
Wisconsin
$323.33$323.33
Alabama
$323.00$323.00
Nebraska
$322.57$322.57
Iowa
$322.44$322.44
Arkansas
$321.32$321.32

Billed by 1 specialties

Commercial rates for 99469

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

See negotiated rates