# CPT 99472: Pediatric critical care, subsequent inpatient care, per day, for a critically ill infant

Medicare 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.

Web page: https://www.med-reveal.com/rates/99472-cpt-fee-schedule
Section: Evaluation and Management
Billed by: Evaluation

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $351.71 |
| National facility | $351.71 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $480.71 | $480.71 |
| District of Columbia | $379.96 | $379.96 |
| New York | $378.90 | $378.90 |
| New Jersey | $375.31 | $375.31 |
| Florida | $370.27 | $370.27 |
| Illinois | $368.08 | $368.08 |
| Connecticut | $366.16 | $366.16 |
| Washington | $365.20 | $365.20 |
| California | $364.40 | $364.40 |
| Massachusetts | $364.37 | $364.37 |
| Maryland | $359.47 | $359.47 |
| Rhode Island | $356.85 | $356.85 |
| Michigan | $355.62 | $355.62 |
| 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 | $352.00 | $352.00 |
| 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 |

## Related codes

- 99291: Critical care, evaluation and management of the critically ill or injured patient, first 30-74 minutes — https://www.med-reveal.com/rates/99291-cpt-fee-schedule
- 99292: Critical care, each additional 30 minutes (add-on) — https://www.med-reveal.com/rates/99292-cpt-fee-schedule
- 99468: Neonatal critical care, initial inpatient care, per day, for a critically ill neonate (28 days of age or younger) — https://www.med-reveal.com/rates/99468-cpt-fee-schedule
- 99469: Neonatal critical care, subsequent inpatient care, per day, for a critically ill neonate — https://www.med-reveal.com/rates/99469-cpt-fee-schedule
- 99471: Pediatric critical care, initial inpatient care, per day, for a critically ill infant (29 days through 24 months) — https://www.med-reveal.com/rates/99471-cpt-fee-schedule
- 99475: Pediatric critical care, initial inpatient care, per day, for a critically ill patient (2 through 5 years) — https://www.med-reveal.com/rates/99475-cpt-fee-schedule
- 99476: Pediatric critical care, subsequent inpatient care, per day, for a critically ill patient — https://www.med-reveal.com/rates/99476-cpt-fee-schedule
- 99477: Initial hospital care, per day, for a neonate requiring intensive observation, not critically ill — https://www.med-reveal.com/rates/99477-cpt-fee-schedule

Commercial negotiated rates for 99472 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules