CPT 99478

Subsequent Intensive Care Infant < 1500 Grams

CPT 99478 pays $115.90 in a non-facility setting and $115.90 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $110.56 in Arkansas to $160.47 in Alaska, a 45% spread.

National non-facility rate

$115.90

Office and other outpatient settings

Facility rate
$115.90

Hospital and ASC settings

Highest state
$160.47

Alaska

Lowest state
$110.56

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 $115.90
CPT 99478 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $115.90, national facility $115.90.
StateRate compared visuallyNon-facilityFacility
Alaska
$160.47$160.47
District of Columbia
$124.77$124.77
New York
$124.42$124.42
New Jersey
$123.41$123.41
Florida
$121.34$121.34
Illinois
$120.78$120.78
Connecticut
$120.35$120.35
Washington
$120.17$120.17
California
$119.96$119.96
Massachusetts
$119.90$119.90
Maryland
$118.32$118.32
Rhode Island
$117.64$117.64
Michigan
$117.09$117.09
Colorado
$116.94$116.94
Pennsylvania
$116.74$116.74
Georgia
$116.31$116.31
Oregon
$116.05$116.05
Hawaii
$116.03$116.03
Puerto Rico
$116.02$116.02
Virgin Islands
$116.02$116.02
New Hampshire
$115.94$115.94
West Virginia
$115.94$115.94
Montana
$115.89$115.89
Texas
$115.72$115.72
Delaware
$115.57$115.57
New Mexico
$115.52$115.52
Nevada
$114.97$114.97
Louisiana
$114.57$114.57
Arizona
$114.51$114.51
Wyoming
$114.42$114.42
Ohio
$114.35$114.35
Missouri
$114.30$114.30
Utah
$114.22$114.22
Virginia
$113.92$113.92
South Carolina
$113.65$113.65
Kentucky
$113.38$113.38
Maine
$112.96$112.96
Vermont
$112.91$112.91
Oklahoma
$112.67$112.67
North Carolina
$112.62$112.62
North Dakota
$112.53$112.53
Minnesota
$112.44$112.44
South Dakota
$112.13$112.13
Mississippi
$111.87$111.87
Indiana
$111.64$111.64
Tennessee
$111.60$111.60
Idaho
$111.44$111.44
Kansas
$111.32$111.32
Wisconsin
$111.20$111.20
Alabama
$111.14$111.14
Nebraska
$110.95$110.95
Iowa
$110.92$110.92
Arkansas
$110.56$110.56

Billed by 1 specialties

Commercial rates for 99478

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

See negotiated rates