FeeBase
Log inGet started
Menu

CPT code 99480: Infant intensive care, 2,501–5,000 grams2026 Medicare rate & RVUs

Reports a subsequent hospital day of intensive evaluation and management for an infant in the 2,501–5,000-gram weight band who continues to need intensive care.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $101.20 for 99480 nationally in a facility.

Medicare rate · 99480

Infant intensive care, 2,501–5,000 grams

Office or facility?

Work RVUs
2.4
Total RVUs
3.03
Global days
XXX

National rate · 2026

$101.20

Facility setting, before claim adjustments.

See every locality for 99480 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 99480 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 99480 covers

99480 represents a subsequent hospital day of intensive evaluation and management for an infant in the 2,501–5,000-gram weight band. Neonatologists and pediatricians commonly report it in a neonatal or pediatric intensive care setting when the infant still needs close monitoring and active management, such as ongoing respiratory support, apnea surveillance, or feeding advancement after prematurity or neonatal illness.

Use this code for a subsequent day rather than the initial hospital-care service, and select the weight band using the infant’s documented weight. The record should support continued intensive-care needs and show the practitioner’s assessment, management, and relevant interventions for that date. A routine nursery visit or uncomplicated daily check does not, by itself, describe the intensive-care service represented by this code.

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 99480 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

99480 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$97.03
AlaskaUnavailable$140.08
ArizonaUnavailable$99.99
ArkansasUnavailable$96.51
Atlanta, GAUnavailable$102.71
Austin, TXUnavailable$101.72
Bakersfield, CAUnavailable$102.31
Baltimore area, MDUnavailable$104.85
Beaumont, TXUnavailable$99.41
Brazoria, TXUnavailable$100.60

99480 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

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
99480 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

How the 99480 rate is calculated

Each of 99480’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 · 99480

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.40

2.40 RVUs× 1.000 GPCI

Practice expense0.48

0.48 RVUs× 1.000 GPCI

Malpractice0.15

0.15 RVUs× 1.000 GPCI

Adjusted RVUs

3.0300

Conversion factor

$33.4009

Medicare rate

$101.20

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

Payment rules and modifiers for 99480

99480 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 · 99480

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

—

99480 isn’t priced in this setting.

99480 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 99480

    Infant intensive care, 2,501–5,000 grams2.4 wRVU

    Not priced

  • 99479

    Neonatal intensive care, 1,500–2,500 grams2.5 wRVU

    Not priced

  • 99478

    Infant intensive care, current weight under 1,500 grams2.75 wRVU

    Not priced

  • 99477

    Neonatal care, initial intensive-care day7 wRVU

    Not priced

  • 99469

    Neonatal critical care, subsequent day7.99 wRVU

    Not priced

How to choose

99479Neonatal intensive care1,500–2,500 grams
Both describe subsequent intensive care, but 99479 is for the 1,500–2,500-gram band; 99480 is for the 2,501–5,000-gram band.
99478Infant intensive careCurrent weight under 1,500 grams
99478 is for an infant weighing less than 1,500 grams. Use 99480 for the 2,501–5,000-gram band.
99477Neonatal careInitial intensive-care day
99477 describes the initial hospital-care day for a neonate needing intensive observation and management. 99480 is for a subsequent day and uses the infant’s weight band.
99469Neonatal critical careSubsequent day
99469 is subsequent neonatal critical care for a critically ill or injured neonate; 99480 describes subsequent intensive care by weight band.

Codes related to 99480

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

Codes related to 99480
CodeHow it relatesNational office range
Same family
99478Infant intensive care, current weight under 1,500 gramsSubsequent intensive care for an infant in the less-than-1,500-gram weight band.No office rate
99479Neonatal intensive care, 1,500–2,500 gramsSubsequent intensive care for an infant in the 1,500–2,500-gram weight band.No office rate
Used instead
99477Neonatal care, initial intensive-care dayInitial hospital-care service for a neonate requiring intensive observation and management.No office rate
99469Neonatal critical care, subsequent daySubsequent neonatal critical care for a critically ill or injured neonate.No office rate
99468Neonatal critical care, initial dayInitial neonatal critical care for a critically ill or injured neonate.No office rate

99480 billing questions

How is 99480 distinguished from 99479?

Both report subsequent intensive care by infant weight band. Use 99480 for the 2,501–5,000-gram band and 99479 for the 1,500–2,500-gram band.

Is 99480 reported for the initial hospital-care day?

No. It represents a subsequent day; 99477 is the related initial hospital-care service for a neonate requiring intensive observation and management.

Is 99480 billed by the day or by time?

It is a daily service. The documentation should support the infant’s need for intensive care and the practitioner’s management on the date reported.

How does 99480 differ from 99469?

99480 identifies subsequent intensive care within a weight band. 99469 is for subsequent neonatal critical care when the neonate is critically ill or injured.

What weight documentation supports 99480?

Document the infant’s weight used to select the 2,501–5,000-gram band, along with the clinical findings, ongoing care needs, and management for that day.

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 99480PPRRVU2026_Oct_nonQPP.csv, line 13,147 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 99480 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 99480 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist