CPT code 99468: Neonatal critical care, initial day2026 Medicare rate & RVUs in Aurora, Illinois

CPT 99468: $789.23–$815.63 facility across 2 localities in Aurora, IL in 2026 Medicare. Compare each area.

CMS RVU26DEffective Oct 1, 20262 payment localities

CMS doesn’t publish an office rate for 99468 in Aurora, Illinois.

—Office (non-facility)
$789.23–$815.63Hospital or facility

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 99468 for the payment locality that covers the ZIP.

On this page 6 sections
  1. Rate in Aurora, Illinois
  2. By payment locality
  3. City and payment areas
  4. How it’s calculated
  5. Payment rules
  6. Sources

Where 99468 pays more and less in Aurora, Illinois

Aurora, Illinois maps to 2 Medicare payment localities in our Census-to-CMS crosswalk. A city name alone doesn’t confirm an address’s payment area.

99468 office and facility rates by payment locality
Payment localityOfficeFacility
Rest of IllinoisUnavailable$789.23
Suburban Chicago, ILUnavailable$815.63

How payment areas work in Aurora

City limits and Medicare payment areas are different maps. These are the payment areas that cover the city’s counties; the service ZIP decides which one applies.

  • Suburban Chicago · DuPage County, Kane County, Will County
  • Rest of Illinois · Kendall County

City boundaries: 2026 Census geography · Census source · CMS county-to-locality definitions

How the 99468 rate is calculated

Each of 99468’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 · 99468

RVUs × geographic indexes × conversion factor

Office or facility?

Work18.46

18.46 RVUs× 1.000 GPCI

Practice expense3.71

3.71 RVUs× 1.000 GPCI

Malpractice1.14

1.14 RVUs× 1.000 GPCI

Adjusted RVUs

23.3100

Conversion factor

$33.4009

Medicare rate

$778.57

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

Payment rules and modifiers for 99468

99468 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 · 99468

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

—

99468 isn’t priced in this setting.

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 99468PPRRVU2026_Oct_nonQPP.csv, line 13,135 (RVU26D)

Open CMS sourceHow we calculate rates

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