Billing code 99477: Neonatal careMedicare rate & RVUs in Guam
Reports the initial hospital day of intensive evaluation and management for a neonate 28 days old or younger who needs frequent interventions but is not critically ill.
CMS doesn’t publish an office rate for 99477 in Guam.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 99477 covers
A neonatologist, pediatrician, or other qualified physician reports 99477 for the initial hospital day when a neonate 28 days old or younger needs intensive observation, frequent interventions, and other intensive care services, without meeting the circumstances for neonatal critical care. The infant may be cared for in a neonatal intensive care unit or another hospital setting providing this level of care. The service reflects active physician management, not routine newborn examination or ordinary nursery care.
Report the code once for the initial day of qualifying neonatal intensive care. Documentation should establish the infant’s age, clinical condition, need for close observation and interventions, and the physician’s evaluation and management that day. For a subsequent day of intensive care, select the applicable subsequent-care code based on the infant’s circumstances and birth-weight category. When the neonate is critically ill and receives neonatal critical care, use the neonatal critical-care code family instead.
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.
99477 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $295.67 |
How the 99477 rate is calculated
Each of 99477’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 · 99477
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.00Practice expense 1.41Malpractice 0.43
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 99477
99477 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 · 99477
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
Non-facility (office) rate · national
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99477 isn’t priced in this setting.
99477 compared with similar codes
Compare codes
99477 vs 99468 vs 99478 vs 99463: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 99468Neonatal critical care
- 99477 is for intensive neonatal hospital care when the neonate is not critically ill. 99468 is used for initial neonatal critical care.
- 99478Infant intensive care
- 99477 covers the initial intensive-care day. 99478 is a subsequent-day intensive-care code for a designated low-birth-weight group.
- 99463Newborn care
- 99463 applies when newborn admission and discharge are on the same date; 99477 is for an initial day requiring intensive neonatal care.
99477 billing questions
How does 99477 differ from 99468?
99477 describes intensive hospital care for a neonate who is not critically ill. Use 99468 when the neonate is critically ill and receives neonatal critical care.
Can 99477 be reported for each day of intensive care?
No. It is for the initial hospital day of qualifying neonatal intensive care. Subsequent days are reported with the applicable subsequent-care code.
What documentation supports 99477?
Document the neonate’s age and condition, why intensive observation and frequent interventions are needed, and the physician’s evaluation and management on the initial day.
When is 99463 a closer fit?
99463 is for newborn hospital care when admission and discharge occur on the same date. 99477 is for the initial day of intensive neonatal care, not routine same-day newborn care.
Which code is used for a subsequent intensive-care day?
Use the applicable code from the 99478–99480 series for subsequent intensive care, selected according to the infant’s birth-weight category and the code’s requirements.
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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