CPT code 99471: Pediatric critical care, initial day, age 29 days–24 months2026 Medicare rate & RVUs in Puerto Rico

In Puerto Rico, Medicare pays $675.05 for 99471 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 99471 nationwide

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

What 99471 covers

99471 represents the initial day of inpatient critical care management for an infant aged 29 days through 24 months whose illness or injury requires intensive physician evaluation and management. It is typically reported by a pediatric intensivist or another physician managing a critically ill infant in a pediatric intensive care unit. Examples of situations may include severe respiratory failure or circulatory instability requiring intensive management; routine inpatient care for a stable infant is not the service described by this code.

Report the code for the initial day of critical care in this age group, rather than for a subsequent day. Documentation should establish the infant’s age, critical illness or injury, the intensive evaluation and management provided, and that this is the initial day. Use the age-appropriate neonatal or older-child code when the patient falls outside this code’s age range.

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 Puerto Rico compares for 99471

Across 109 of 109 payment localities, the facility rate for 99471 runs from $643.16 in Arkansas to $933.38 in Alaska. Puerto Rico pays $675.05. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

99471 rates by state

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

See 99471 in every payment locality

How the 99471 rate is calculated

Each of 99471’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.

Payment rules and modifiers for 99471

99471 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.

Codes related to 99471

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 99471 has changed in Puerto Rico

Price 99471 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

• Aceitunas
• Adjuntas
• Aguada
• Aguadilla
• Aguas Buenas
• Aguas Claras
• Aguilita
• Aibonito

Browse all communities in Puerto Rico

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

Open CMS sourceHow we calculate rates