CPT 99471

Initial Ped Critical Care 29 Days Thru 24 Months

CPT 99471 pays $674.36 in a non-facility setting and $674.36 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $643.16 in Arkansas to $933.38 in Alaska, a 45% spread.

National non-facility rate

$674.36

Office and other outpatient settings

Facility rate
$674.36

Hospital and ASC settings

Highest state
$933.38

Alaska

Lowest state
$643.16

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 $674.36
CPT 99471 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $674.36, national facility $674.36.
StateRate compared visuallyNon-facilityFacility
Alaska
$933.38$933.38
District of Columbia
$726.07$726.07
New York
$723.99$723.99
New Jersey
$718.13$718.13
Florida
$706.03$706.03
Illinois
$702.73$702.73
Connecticut
$700.26$700.26
Washington
$699.26$699.26
California
$698.07$698.07
Massachusetts
$697.68$697.68
Maryland
$688.44$688.44
Rhode Island
$684.48$684.48
Michigan
$681.28$681.28
Colorado
$680.41$680.41
Pennsylvania
$679.24$679.24
Georgia
$676.72$676.72
Oregon
$675.25$675.25
Hawaii
$675.18$675.18
Puerto Rico
$675.05$675.05
Virgin Islands
$675.05$675.05
New Hampshire
$674.64$674.64
West Virginia
$674.53$674.53
Montana
$674.30$674.30
Texas
$673.28$673.28
Delaware
$672.40$672.40
New Mexico
$672.08$672.08
Nevada
$668.95$668.95
Louisiana
$666.56$666.56
Arizona
$666.27$666.27
Wyoming
$665.77$665.77
Ohio
$665.27$665.27
Missouri
$664.99$664.99
Utah
$664.54$664.54
Virginia
$662.81$662.81
South Carolina
$661.23$661.23
Kentucky
$659.62$659.62
Maine
$657.23$657.23
Vermont
$656.95$656.95
Oklahoma
$655.48$655.48
North Carolina
$655.22$655.22
North Dakota
$654.72$654.72
Minnesota
$654.20$654.20
South Dakota
$652.41$652.41
Mississippi
$650.78$650.78
Indiana
$649.52$649.52
Tennessee
$649.27$649.27
Idaho
$648.33$648.33
Kansas
$647.64$647.64
Wisconsin
$646.96$646.96
Alabama
$646.57$646.57
Nebraska
$645.52$645.52
Iowa
$645.28$645.28
Arkansas
$643.16$643.16

Billed by 1 specialties

Commercial rates for 99471

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

See negotiated rates