CPT 99472

Subsq Ped Critical Care 29 Days Thru 24 Mo

CPT 99472 pays $351.71 in a non-facility setting and $351.71 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $333.09 in Arkansas to $480.71 in Alaska, a 44% spread.

National non-facility rate

$351.71

Office and other outpatient settings

Facility rate
$351.71

Hospital and ASC settings

Highest state
$480.71

Alaska

Lowest state
$333.09

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 $351.71
CPT 99472 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $351.71, national facility $351.71.
StateRate compared visuallyNon-facilityFacility
Alaska
$480.71$480.71
District of Columbia
$379.96$379.96
New York
$378.90$378.90
New Jersey
$375.30$375.30
Florida
$370.27$370.27
Illinois
$368.08$368.08
Connecticut
$366.16$366.16
Washington
$365.20$365.20
California
$364.41$364.41
Massachusetts
$364.37$364.37
Maryland
$359.46$359.46
Rhode Island
$356.85$356.85
Michigan
$355.61$355.61
Colorado
$354.86$354.86
Pennsylvania
$354.11$354.11
Georgia
$352.91$352.91
Hawaii
$352.52$352.52
Puerto Rico
$352.14$352.14
Virgin Islands
$352.14$352.14
Oregon
$351.99$351.99
New Hampshire
$351.97$351.97
Montana
$351.67$351.67
West Virginia
$351.49$351.49
Texas
$350.79$350.79
Delaware
$350.30$350.30
New Mexico
$350.17$350.17
Nevada
$348.54$348.54
Louisiana
$346.93$346.93
Arizona
$346.89$346.89
Wyoming
$346.67$346.67
Ohio
$346.17$346.17
Missouri
$346.02$346.02
Utah
$345.81$345.81
Virginia
$344.90$344.90
South Carolina
$343.83$343.83
Kentucky
$342.80$342.80
Maine
$341.56$341.56
Vermont
$341.49$341.49
Oklahoma
$340.39$340.39
North Carolina
$340.33$340.33
North Dakota
$340.20$340.20
Minnesota
$339.97$339.97
South Dakota
$338.85$338.85
Mississippi
$337.56$337.56
Indiana
$336.97$336.97
Tennessee
$336.78$336.78
Idaho
$336.26$336.26
Kansas
$335.82$335.82
Wisconsin
$335.56$335.56
Alabama
$335.12$335.12
Nebraska
$334.62$334.62
Iowa
$334.47$334.47
Arkansas
$333.09$333.09

Billed by 1 specialties

Commercial rates for 99472

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

See negotiated rates