# CPT 99475: Pediatric critical care, initial inpatient care, per day, for a critically ill patient (2 through 5 years)

Medicare CPT 99475 pays $473.96 in a non-facility setting and $473.96 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $452.30 in Arkansas to $656.55 in Alaska, a 45% spread.

Web page: https://www.med-reveal.com/rates/99475-cpt-fee-schedule
Section: Evaluation and Management
Billed by: Evaluation

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $473.96 |
| National facility | $473.96 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $656.55 | $656.55 |
| District of Columbia | $510.25 | $510.25 |
| New York | $508.66 | $508.66 |
| New Jersey | $504.70 | $504.70 |
| Florida | $495.71 | $495.71 |
| Illinois | $493.42 | $493.42 |
| Connecticut | $492.06 | $492.06 |
| Washington | $491.58 | $491.58 |
| California | $490.86 | $490.86 |
| Massachusetts | $490.44 | $490.44 |
| Maryland | $483.81 | $483.81 |
| Rhode Island | $481.14 | $481.14 |
| Michigan | $478.61 | $478.61 |
| Colorado | $478.32 | $478.32 |
| Pennsylvania | $477.36 | $477.36 |
| Georgia | $475.52 | $475.52 |
| Hawaii | $474.74 | $474.74 |
| Oregon | $474.73 | $474.73 |
| Puerto Rico | $474.45 | $474.45 |
| Virgin Islands | $474.45 | $474.45 |
| New Hampshire | $474.21 | $474.21 |
| Montana | $473.91 | $473.91 |
| West Virginia | $473.86 | $473.86 |
| Texas | $473.24 | $473.24 |
| Delaware | $472.64 | $472.64 |
| New Mexico | $472.26 | $472.26 |
| Nevada | $470.24 | $470.24 |
| Louisiana | $468.46 | $468.46 |
| Arizona | $468.35 | $468.35 |
| Wyoming | $468.05 | $468.05 |
| Ohio | $467.57 | $467.57 |
| Missouri | $467.39 | $467.39 |
| Utah | $467.11 | $467.11 |
| Virginia | $466.00 | $466.00 |
| South Carolina | $464.81 | $464.81 |
| Kentucky | $463.65 | $463.65 |
| Maine | $462.12 | $462.12 |
| Vermont | $461.98 | $461.98 |
| Oklahoma | $460.82 | $460.82 |
| North Carolina | $460.70 | $460.70 |
| North Dakota | $460.47 | $460.47 |
| Minnesota | $460.16 | $460.16 |
| South Dakota | $458.88 | $458.88 |
| Mississippi | $457.54 | $457.54 |
| Indiana | $456.77 | $456.77 |
| Tennessee | $456.57 | $456.57 |
| Idaho | $455.95 | $455.95 |
| Kansas | $455.45 | $455.45 |
| Wisconsin | $455.07 | $455.07 |
| Alabama | $454.67 | $454.67 |
| Nebraska | $454.02 | $454.02 |
| Iowa | $453.85 | $453.85 |
| Arkansas | $452.30 | $452.30 |

## 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
- 99472: Pediatric critical care, subsequent inpatient care, per day, for a critically ill infant — https://www.med-reveal.com/rates/99472-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 99475 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