CPT code 99463: Newborn care, admission and discharge same day2026 Medicare rate & RVUs in West Virginia

Reports hospital or birthing-center evaluation and management for a normal newborn whose admission and discharge occur on the same date.

CMS RVU26DEffective Oct 1, 2026One payment locality33 Medicare services in 2024

In West Virginia, Medicare pays $94.19 for 99463 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$94.19Hospital or facility

Check a contract rate as a % of Medicare · 99463 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 99463 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in West Virginia
  2. What 99463 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 99463 covers

This service covers the same-day hospital or birthing-center care of a normal newborn, including the initial evaluation and management and the discharge-related care. It is typically performed by a physician or other qualified clinician responsible for the newborn’s care during the stay. The code is specific to a newborn admitted and discharged on the same calendar date; it is not the selection for a newborn who remains admitted for a later date.

Report one same-day episode for the infant rather than separate newborn-care entries for admission and discharge. Documentation should support the newborn’s normal status, the initial assessment and management, and the same-date admission and discharge. The CMS physician fee schedule assigns physician-work and practice-expense values to this service. Choose among newborn-care codes according to the care setting, whether the service is initial or subsequent, and whether discharge occurs that day.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How West Virginia compares for 99463

Across 109 of 109 payment localities, the facility rate for 99463 runs from $90.02 in Arkansas to $129.74 in Alaska. West Virginia pays $94.19. The RVUs are the same everywhere; the geographic indexes change the dollars.

99463 in West Virginia vs other payment areas
  1. West Virginia · this page$94.19
  2. Los Angeles, CA · California$99.86+$5.67
  3. Washington, DC area · District of Columbia$102.64+$8.45
  4. Miami, FL · Florida$102.29+$8.10
  5. Chicago, IL · Illinois$101.08+$6.89
  6. Manhattan, NY · New York$105.09+$10.90
  7. Alaska · Alaska$129.74+$35.55

Other areas in West Virginia first, then benchmark localities. Bars start at $0.

Every other payment area

99463 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$90.55
ArkansasArkansas—$90.02
ArizonaArizona—$93.63
Bakersfield, CACalifornia—$96.37
Chico, CACalifornia—$95.91
El Centro, CACalifornia—$95.93
Fresno, CACalifornia—$95.91
Hanford, CACalifornia—$95.91

99463 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
99463 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 99463 in every payment locality

How the 99463 rate is calculated

Each of 99463’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 99463

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.13

2.13 RVUs× 1.000 GPCI

Practice expense0.58

0.58 RVUs× 1.000 GPCI

Malpractice0.13

0.13 RVUs× 1.000 GPCI

Adjusted RVUs

2.8400

Conversion factor

$33.4009

Medicare rate

$94.86

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact West Virginia inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,130

Code
99463
Physician work
2.13
Practice expense
0.58
Malpractice
0.13

GPCI2026.csv

110

Locality
West Virginia
Physician work
1.000
Practice expense
0.869
Malpractice
1.431
Facility calculation for 99463 in West Virginia
ComponentRVULocality factorAdjusted
Physician work2.13× 1.0002.1300
Practice expense0.58× 0.8690.5040
Malpractice0.13× 1.4310.1860
Total RVUs2.8200
Conversion factor× 33.4009

Facility rate, West Virginia$94.19

Facility: (2.13 × 1 + 0.58 × 0.869 + 0.13 × 1.431) × $33.4009 = $94.19

Open 99463 in the RVU calculator

Payment rules and modifiers for 99463

99463 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · 99463

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

99463 isn’t priced in this setting.

How 99463 has changed in West Virginia

99463 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$94.19RVU26D
2026-07-01Not available in this setting$94.19RVU26C
2026-04-01Not available in this setting$94.19RVU26B
2026-01-01Not available in this setting$94.19RVU26A
2025-10-01Not available in this setting$101.45RVU25D
2025-07-01Not available in this setting$101.45RVU25C
2025-04-01Not available in this setting$101.45RVU25B
2025-01-01Not available in this setting$101.45RVU25A
2024-10-01Not available in this setting$104.24RVU24D
2024-07-01Not available in this setting$104.24RVU24C
2024-04-01Not available in this setting$104.24RVU24B
2024-03-09Not available in this setting$104.24RVU24AR
2024-01-01Not available in this setting$102.54RVU24A
2023-10-01Not available in this setting$106.28RVU23D
2023-07-01Not available in this setting$106.28RVU23C
2023-04-01Not available in this setting$106.28RVU23B
2023-01-01Not available in this setting$106.28RVU23A
2022-10-01Not available in this setting$106.00RVU22D
2022-07-01Not available in this setting$106.00RVU22C
2022-04-01Not available in this setting$106.00RVU22B
2022-01-01Not available in this setting$106.00RVU22A
2021-10-01Not available in this setting$106.82RVU21D
2021-07-01Not available in this setting$106.82RVU21C
2021-04-01Not available in this setting$106.82RVU21B
2021-01-01Not available in this setting$106.82RVU21A
2020-10-01Not available in this setting$109.32RVU20D
2020-07-01Not available in this setting$109.32RVU20C
2020-04-01Not available in this setting$109.32RVU20B
2020-01-01Not available in this setting$109.32RVU20A
2019-10-01Not available in this setting$109.86RVU19D
2019-07-01Not available in this setting$109.86RVU19C
2019-04-01Not available in this setting$109.86RVU19B
2019-01-01Not available in this setting$109.86RVU19A
2018-10-01Not available in this setting$110.05RVU18D
2018-07-01Not available in this setting$110.05RVU18C
2018-04-01Not available in this setting$110.05RVU18B
2018-01-01Not available in this setting$110.05RVU18AR1
2017-10-01Not available in this setting$116.66RVU17D
2017-07-01Not available in this setting$116.66RVU17C
2017-04-01Not available in this setting$116.66RVU17B
2017-01-01Not available in this setting$116.66RVU17A
2016-10-01Not available in this setting$115.32RVU16D
2016-07-01Not available in this setting$115.32RVU16C
2016-04-01Not available in this setting$115.32RVU16B
2016-01-01Not available in this setting$115.32RVU16A
2015-10-01Not available in this setting$116.49RVU15D
2015-07-01Not available in this setting$116.49RVU15C
2015-04-01Not available in this setting$115.91RVU15B
2015-01-01Not available in this setting$115.91RVU15A
2014-10-01Not available in this setting$110.16RVU14D
2014-07-01Not available in this setting$110.16RVU14C
2014-04-01Not available in this setting$110.16RVU14B
2014-01-01Not available in this setting$110.16RVU14A
2013-10-01Not available in this setting$107.21RVU13D
2013-07-01Not available in this setting$107.21RVU13C
2013-04-01Not available in this setting$107.21RVU13B
2013-01-01Not available in this setting$107.21RVU13AR

Price 99463 for an earlier date of service

Where the West Virginia rate applies

West Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 439 cities and communities in West Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Accoville
  • Addison (Webster Springs)
  • Adrian
  • Albright
  • Alderson
  • Alum Creek
  • Amherstdale
  • Anawalt

Browse all communities in West Virginia

99463 billing questions

When should 99463 be used instead of 99460?

Use 99463 when the normal newborn is admitted to a hospital or birthing center and discharged on the same date. Use 99460 for initial hospital or birthing-center newborn care when the same-day discharge circumstance does not apply.

Can 99463 be reported for newborn care outside a hospital or birthing center?

No. For initial care of a normal newborn in a non-facility setting, consider 99461 instead.

How does 99463 differ from 99462?

99463 represents the same-day admission and discharge episode. 99462 is for subsequent daily care of a normal newborn who remains in the hospital or birthing center.

Should admission and discharge be coded as two separate newborn-care services?

No. 99463 represents the same-day newborn-care episode, including the initial and discharge-related care.

What documentation supports 99463?

Document the newborn’s normal status, the initial evaluation and management, and the admission and discharge dates showing both occurred on the same date.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 99463PPRRVU2026_Oct_nonQPP.csv, line 13,130 (RVU26D)
Geographic factors for West VirginiaGPCI2026.csv, line 110 (RVU26D)

Open CMS sourceHow we calculate rates

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