CPT code 99480: Infant intensive care, 2,501–5,000 grams2026 Medicare rate & RVUs in Missouri
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 doesn’t publish an office rate for 99480 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $100.11 |
| Metropolitan St. Louis, MO | Unavailable | $100.45 |
| Rest of Missouri | Unavailable | $98.86 |
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
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
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99480 isn’t priced in this setting.
99480 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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