CPT code 99465: Newborn resuscitation2026 Medicare rate & RVUs in Washington
Reports active resuscitation of a newborn in the delivery or birthing room, such as positive-pressure ventilation or chest compressions.
CMS doesn’t publish an office rate for 99465 in Washington.
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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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 in Washington
| Payment locality | Office | Facility |
|---|---|---|
| King County, WA | Unavailable | $131.85 |
| Rest of Washington | Unavailable | $124.46 |
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.
How the rate is built · 99465
RVUs × geographic indexes × conversion factor
Work2.93
2.93 RVUs× 1.000 GPCI
Practice expense0.59
0.59 RVUs× 1.000 GPCI
Malpractice0.18
0.18 RVUs× 1.000 GPCI
Adjusted RVUs
3.7000
Conversion factor
$33.4009
Medicare rate
$123.58
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
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.
Place of service · 99465
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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99465 isn’t priced in this setting.
99465 compared with similar codes
Compare codes · National
4 codes, side by side
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.
99465 billing questions
How is 99465 different from 99464?
99465 is for active delivery-room resuscitation, such as positive-pressure ventilation or chest compressions. 99464 describes attendance at delivery and initial stabilization without that resuscitation service.
Should intubation or medication administration be coded separately?
These interventions may be part of the newborn resuscitation reported with 99465. Document what was performed as part of the resuscitation rather than treating each intervention as a separate 99465 service.
What documentation supports 99465?
Document the newborn’s condition, the resuscitative measures provided, and the response. Include details such as ventilation, chest compressions, intubation, or medication administration when performed.
Can 99465 be reported with initial newborn hospital care?
The services describe different work: 99465 covers delivery-room resuscitation, while 99460 covers initial newborn hospital care. Documentation should establish the distinct service provided for each.
Is 99465 for neonatal intensive care after delivery?
No. It describes resuscitation in the delivery or birthing room. Neonatal critical care after delivery is represented by a different service, such as 99468.
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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