CPT code 99465: Newborn resuscitation2026 Medicare rate & RVUs

Medicare pays $123.58 for 99465 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 99465 covers

CPT 99465 describes active resuscitation of a newborn in the delivery or birthing room, including measures such as positive-pressure ventilation or chest compressions. A physician or other qualified clinician with responsibility for newborn resuscitation may provide the service in a hospital delivery suite or birthing room. Endotracheal intubation and medication administration may be part of the resuscitation when clinically needed.

Select this code for the resuscitation service itself, not simply for being present at delivery or providing initial stabilization. The record should identify the resuscitative measures performed and the newborn’s condition and response. Distinguish this service from routine newborn hospital care or neonatal critical care based on the service delivered and its setting. The supplied CMS facts list no special payment rule for this code; payment is valued under the physician fee schedule.

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 99465 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

99465 rates by state

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

How the 99465 rate is calculated

Each of 99465’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 99465

99465 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.

99465 compared with similar codes

How to choose

99464Delivery attendance

Use 99464 for attendance at delivery and initial stabilization. Use 99465 when active delivery-room resuscitation, such as positive-pressure ventilation or chest compressions, is provided.

99460Newborn care

99460 represents initial newborn hospital care, not delivery-room resuscitation. The services may describe distinct work when both are provided and documented.

99468Neonatal critical care

99468 represents initial neonatal critical care, rather than resuscitation performed in the delivery or birthing room.

Codes related to 99465

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