CPT code 99477: Neonatal care, initial intensive-care day2026 Medicare rate & RVUs in Washington, DC area

Reports the initial hospital day of intensive evaluation and management for a neonate 28 days old or younger who needs frequent interventions but is not critically ill.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Washington, DC area, Medicare pays $317.90 for 99477 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$317.90Hospital or facility

Check a contract rate as a % of Medicare · 99477 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 99477 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 99477 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 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.

How Washington, DC area compares for 99477

Across 109 of 109 payment localities, the facility rate for 99477 runs from $281.66 in Arkansas to $408.78 in Alaska. Washington, DC area pays $317.90. The RVUs are the same everywhere; the geographic indexes change the dollars.

99477 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$317.90
  2. Los Angeles, CA · California$308.64−$9.26
  3. Miami, FL · Florida$319.15+$1.25
  4. Chicago, IL · Illinois$315.74−$2.16
  5. Manhattan, NY · New York$326.27+$8.37
  6. Alaska · Alaska$408.78+$90.88
  7. Alabama · Alabama$283.14−$34.76

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

99477 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas—$281.66
ArizonaArizona—$291.74
Bakersfield, CACalifornia—$298.61
Chico, CACalifornia—$297.10
El Centro, CACalifornia—$297.17
Fresno, CACalifornia—$297.10
Hanford, CACalifornia—$297.10
Madera, CACalifornia—$297.10

99477 rates by state

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

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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
99477 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 99477 in every payment locality

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.

How the rate is built · 99477

RVUs × geographic indexes × conversion factor

Office or facility?

Work7.00

7.00 RVUs× 1.000 GPCI

Practice expense1.41

1.41 RVUs× 1.000 GPCI

Malpractice0.43

0.43 RVUs× 1.000 GPCI

Adjusted RVUs

8.8400

Conversion factor

$33.4009

Medicare rate

$295.26

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,144

Code
99477
Physician work
7.00
Practice expense
1.41
Malpractice
0.43

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Facility calculation for 99477 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work7.00× 1.0547.3780
Practice expense1.41× 1.1781.6610
Malpractice0.43× 1.1130.4786
Total RVUs9.5176
Conversion factor× 33.4009

Facility rate, Washington, DC area$317.90

Facility: (7 × 1.054 + 1.41 × 1.178 + 0.43 × 1.113) × $33.4009 = $317.90

Open 99477 in the RVU calculator

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.

Place of service · 99477

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

—

99477 isn’t priced in this setting.

How 99477 has changed in Washington, DC area

99477 · 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$317.90RVU26D
2026-07-01Not available in this setting$317.90RVU26C
2026-04-01Not available in this setting$317.90RVU26B
2026-01-01Not available in this setting$317.90RVU26A
2025-10-01Not available in this setting$355.01RVU25D
2025-07-01Not available in this setting$355.01RVU25C
2025-04-01Not available in this setting$355.01RVU25B
2025-01-01Not available in this setting$355.01RVU25A
2024-10-01Not available in this setting$366.15RVU24D
2024-07-01Not available in this setting$366.15RVU24C
2024-04-01Not available in this setting$366.15RVU24B
2024-03-09Not available in this setting$366.15RVU24AR
2024-01-01Not available in this setting$360.17RVU24A
2023-10-01Not available in this setting$374.59RVU23D
2023-07-01Not available in this setting$374.59RVU23C
2023-04-01Not available in this setting$374.59RVU23B
2023-01-01Not available in this setting$374.59RVU23A
2022-10-01Not available in this setting$385.83RVU22D
2022-07-01Not available in this setting$385.83RVU22C
2022-04-01Not available in this setting$385.83RVU22B
2022-01-01Not available in this setting$385.83RVU22A
2021-10-01Not available in this setting$385.15RVU21D
2021-07-01Not available in this setting$385.15RVU21C
2021-04-01Not available in this setting$385.15RVU21B
2021-01-01Not available in this setting$385.15RVU21A
2020-10-01Not available in this setting$392.40RVU20D
2020-07-01Not available in this setting$392.40RVU20C
2020-04-01Not available in this setting$392.40RVU20B
2020-01-01Not available in this setting$392.40RVU20A
2019-10-01Not available in this setting$388.28RVU19D
2019-07-01Not available in this setting$388.28RVU19C
2019-04-01Not available in this setting$388.28RVU19B
2019-01-01Not available in this setting$388.28RVU19A
2018-10-01Not available in this setting$389.18RVU18D
2018-07-01Not available in this setting$389.18RVU18C
2018-04-01Not available in this setting$389.18RVU18B
2018-01-01Not available in this setting$389.18RVU18AR1
2017-10-01Not available in this setting$394.06RVU17D
2017-07-01Not available in this setting$394.06RVU17C
2017-04-01Not available in this setting$394.06RVU17B
2017-01-01Not available in this setting$394.06RVU17A
2016-10-01Not available in this setting$397.83RVU16D
2016-07-01Not available in this setting$397.83RVU16C
2016-04-01Not available in this setting$397.83RVU16B
2016-01-01Not available in this setting$397.83RVU16A
2015-10-01Not available in this setting$402.94RVU15D
2015-07-01Not available in this setting$402.94RVU15C
2015-04-01Not available in this setting$400.94RVU15B
2015-01-01Not available in this setting$400.94RVU15A
2014-10-01Not available in this setting$380.89RVU14D
2014-07-01Not available in this setting$380.89RVU14C
2014-04-01Not available in this setting$380.89RVU14B
2014-01-01Not available in this setting$380.89RVU14A
2013-10-01Not available in this setting$373.68RVU13D
2013-07-01Not available in this setting$373.68RVU13C
2013-04-01Not available in this setting$373.68RVU13B
2013-01-01Not available in this setting$373.68RVU13AR

Price 99477 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

99477 billing questions

How does 99477 differ from 99468?

99477 describes intensive hospital care for a neonate who is not critically ill. Use 99468 when the neonate is critically ill and receives neonatal critical care.

Can 99477 be reported for each day of intensive care?

No. It is for the initial hospital day of qualifying neonatal intensive care. Subsequent days are reported with the applicable subsequent-care code.

What documentation supports 99477?

Document the neonate’s age and condition, why intensive observation and frequent interventions are needed, and the physician’s evaluation and management on the initial day.

When is 99463 a closer fit?

99463 is for newborn hospital care when admission and discharge occur on the same date. 99477 is for the initial day of intensive neonatal care, not routine same-day newborn care.

Which code is used for a subsequent intensive-care day?

Use the applicable code from the 99478–99480 series for subsequent intensive care, selected according to the infant’s birth-weight category and the code’s requirements.

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 99477PPRRVU2026_Oct_nonQPP.csv, line 13,144 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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