CPT code 99472: Pediatric critical care, subsequent day, ages 29 days–24 months2026 Medicare rate & RVUs in New Mexico

In New Mexico, Medicare pays $350.17 for 99472 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 99472 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 99472 covers

Code 99472 represents a subsequent day of critical care for a critically ill child aged 29 days through 24 months. Pediatric intensivists, hospitalists, and other physicians may provide this care in an ICU or another setting equipped to manage an immediately threatening condition. Examples include acute respiratory failure, septic shock, or severe cardiac instability when the child needs high-complexity decisions to prevent or manage deterioration in a vital organ system.

Select 99472 for a subsequent day, not the initial 24-hour period; use 99471 for that initial period. The record should support the child’s age, critical illness, threatened organ function, and the physician’s high-complexity management on the billed day. This is a daily service, not a code selected by adding up minutes. Routine assessment and management integral to that day’s critical care are part of the service rather than a separate E/M service for the same work.

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 New Mexico compares for 99472

Across 109 of 109 payment localities, the facility rate for 99472 runs from $333.09 in Arkansas to $480.71 in Alaska. New Mexico pays $350.17. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

99472 rates by state

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

See 99472 in every payment locality

How the 99472 rate is calculated

Each of 99472’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 99472

99472 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 99472

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

How 99472 has changed in New Mexico

Price 99472 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

• Abeytas
• Abiquiu
• Acomita Lake
• Adelino
• Agua Fria
• Alamillo
• Alamo
• Alamogordo

Browse all communities in New Mexico

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