No office rate
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.
On this page
CMS RVU26D · Effective 2026-10-01
99480 Infant intensive care Medicare reimbursement rates in Alabama
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. Compare 99480 office and facility rates across CMS payment localities in Alabama.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 99480 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$97.03
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Neonatal intensive care
About 99480: Subsequent infant intensive care
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.
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.
Where the value comes from
- Work RVU2.40 · 79%
- Practice expense (office) RVU0.48 · 16%
- Malpractice RVU0.15 · 5%
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.
99480 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
99478 is for an infant weighing less than 1,500 grams. Use 99480 for the 2,501–5,000-gram band.
No office rate
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.
No office rate
99469 is subsequent neonatal critical care for a critically ill or injured neonate; 99480 describes subsequent intensive care by weight band.
Compare 99480 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$97.03
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 99480 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
13,147
- Code
- 99480
- Physician work
- 2.40
- Practice expense
- 0.48
- Malpractice
- 0.15
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.40 | × 1.000 | 2.4000 |
| Practice expense | 0.48 | × 0.875 | 0.4200 |
| Malpractice | 0.15 | × 0.566 | 0.0849 |
| Total RVUs | 2.9049 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$97.03
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.4 | 1 |
| Practice expense | 0.48 | 0.875 |
| Malpractice | 0.15 | 0.566 |
(2.4 × 1 + 0.48 × 0.875 + 0.15 × 0.566) × $33.4009 = $97.03
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
13,14499477,,Init day hosp neonate care,A,,7.00,1.41,NA,1.41,,0.43,8.84,8.84,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,14599478,,"Sbsq ic vlbw inf<1,500 gm",A,,2.75,0.55,NA,0.55,,0.17,3.47,3.47,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,14699479,,"Sbsq ic lbw inf 1,500-2,500",A,,2.50,0.50,NA,0.50,,0.15,3.15,3.15,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,14799480,,"Sbsq ic inf pbw 2,501-5,000",A,,2.40,0.48,NA,0.48,,0.15,3.03,3.03,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,14899483,,Assmt & care pln pt cog imp,A,,3.84,4.66,,0.97,,0.27,8.77,5.08,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,14999484,,Care mgmt svc bhvl hlth cond,A,,0.93,0.73,,0.17,,0.06,1.72,1.16,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,15099485,,Suprv interfacilty transport,B,+,1.50,0.33,NA,0.33,,0.08,1.91,1.91,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515