CPT code 99477: Neonatal care, initial intensive-care day2026 Medicare rate & RVUs

Medicare pays $295.26 for 99477 nationally in a facility.

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

What 99477 covers

A neonatologist, pediatrician, or other qualified physician reports 99477 for the initial hospital day when a neonate 28 days old or younger needs intensive observation, frequent interventions, and other intensive care services, without meeting the circumstances for neonatal critical care. The infant may be cared for in a neonatal intensive care unit or another hospital setting providing this level of care. The service reflects active physician management, not routine newborn examination or ordinary nursery care.

Report the code once for the initial day of qualifying neonatal intensive care. Documentation should establish the infant’s age, clinical condition, need for close observation and interventions, and the physician’s evaluation and management that day. For a subsequent day of intensive care, select the applicable subsequent-care code based on the infant’s circumstances and birth-weight category. When the neonate is critically ill and receives neonatal critical care, use the neonatal critical-care code family instead.

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.

Where 99477 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

99477 rates by state

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

How the 99477 rate is calculated

Each of 99477’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 99477

99477 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.

99477 compared with similar codes

How to choose

99468Neonatal critical careInitial day

99477 is for intensive neonatal hospital care when the neonate is not critically ill. 99468 is used for initial neonatal critical care.

99478Infant intensive careCurrent weight under 1,500 grams

99477 covers the initial intensive-care day. 99478 is a subsequent-day intensive-care code for a designated low-birth-weight group.

99463Newborn careAdmission and discharge same day

99463 applies when newborn admission and discharge are on the same date; 99477 is for an initial day requiring intensive neonatal care.

Codes related to 99477

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

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