CPT code 99478: Infant intensive care, current weight under 1,500 grams2026 Medicare rate & RVUs in New Mexico

In New Mexico, Medicare pays $115.52 for 99478 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 99478 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 99478 covers

Code 99478 describes a subsequent day of intensive evaluation and management for a critically ill infant or young child aged 29 days or older whose current body weight is under 1,500 grams. It is typically reported by a neonatologist or pediatrician providing ongoing care in a neonatal or pediatric intensive care setting, where the infant needs intensive observation, frequent interventions, and other intensive services.

Select the code using the patient’s current body weight for the date of service, not birth weight; document that weight and the clinical work supporting intensive care. Report one daily service when the patient meets this code’s weight and care criteria. The 1,500-gram threshold distinguishes this service from the adjacent weight-based subsequent-care codes.

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 99478

Across 109 of 109 payment localities, the facility rate for 99478 runs from $110.56 in Arkansas to $160.47 in Alaska. New Mexico pays $115.52. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

99478 rates by state

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

See 99478 in every payment locality

How the 99478 rate is calculated

Each of 99478’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 99478

99478 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 99478

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

How 99478 has changed in New Mexico

Price 99478 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