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See a sample rate comparisonCPT 99479 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Subsequent Intensive Care Per, Subsequent Intensive Care Per Day For The Evaluation And Management Of The Recovering Low Birth Weight Infant (Present Body Weight Of 1500-2500 Grams)
| Key Fact | Detail |
|---|---|
| Service Type | Evaluation and Management Inpatient Neonatal Intensive Care Services and Pediatric and Neonatal Critical Care Services |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | GC - Service performed by resident under supervision FS - Split/shared E/M visit |
| Complexity Level | Low |
| Medicare Fee Schedule | $105.21 national non-facility rate (2026) · View Medicare rates for 99479 |
| Medicaid Fee Schedule | $98.85 median of the 8 states in the free preview · View Medicaid rates for 99479 |
National average reimbursement for CPT 99479 by major payers:
$163.06
$158.78
$151.22
$202.96
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CPT 99479
5 of 25 sample ratesHigher to lower in this preview
Julia Danser
$685.28Published rateMarianne Borden
Bay Area Surgical Specialists, Inc.
$225.13Published rateAngela Herrmann
Angela Herrmann Md Inc
$173.27Published rateThao Nguyen
$118.86Published rateAlan F Dakak Md Inc, Kern Pediatrics
Alan F. Dakak, M.D., Inc.
$105.59Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 99479 vs. Other Inpatient Neonatal Intensive Care Services and Pediatric and Neonatal Critical Care Services Codes
The CPT 99479 code is part of the Evaluation and Management services used for Inpatient Neonatal Intensive Care Services and Pediatric and Neonatal Critical Care Services. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 99479 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 99469-CPT | Moderate | Subsequent Inpatient Neonatal, Subsequent Inpatient Neonatal Critical Care Per Day For The Evaluation And Management Of A Critically Ill Neonate 28 Days Of Age Or Younger |
| 99477-CPT | Moderate | Init Day Hosp Neonate Care, Initial Hospital Care Per Day For The Evaluation And Management Of The Neonate 28 Days Of Age Or Younger Who Requires Intensive Observation Frequent Interventions And Other Intensive Care Services |
| 99478-CPT | Low | Subsequent Intensive Care Per, Subsequent Intensive Care Per Day For The Evaluation And Management Of The Recovering Very Low Birth Weight Infant (Present Body Weight Less Than 1500 Grams) |
| 99479-CPT | Low | Subsequent Intensive Care Per, Subsequent Intensive Care Per Day For The Evaluation And Management Of The Recovering Low Birth Weight Infant (Present Body Weight Of 1500-2500 Grams) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99479. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99479 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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Frequently Asked Questions
CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit codes used by healthcare providers and payers to describe medical, surgical, and diagnostic services. They are essential for accurate billing and processing of claims.
To find out the cost of a specific medical procedure or service, you can first contact your insurance company or the healthcare provider directly for an estimate. For more granular detail on procedure costs based on CPT codes and your specific location, you can utilize tools like Payerprice. Payerprice offers a fee schedule lookup tool that allows users to search with CPT codes and specific locations to get a better understanding of potential costs.
Healthcare costs can vary significantly due to several factors, including the type of facility (hospital vs. outpatient clinic), the geographic location, the specific provider's negotiated rates with insurance companies, the complexity of the service, and the technology used. These variations often reflect different overhead costs, market demands, and individual provider pricing strategies.
A fee schedule is a complete listing of fees used by healthcare providers for various medical services and procedures. It outlines the maximum fees that providers may charge for each service. Insurance companies also use fee schedules to determine how much they will reimburse providers for specific services. Understanding a fee schedule can help you anticipate out-of-pocket costs for healthcare services.
To compare prices for medical services, you should gather information from multiple sources. Start by asking your healthcare provider for an estimate, and contact your insurance company to understand your out-of-pocket costs for in-network and out-of-network providers. Additionally, you can use specialized tools designed for price transparency. Payerprice, for instance, has a fee schedule lookup tool where you can input a CPT code and your specific location to compare costs for various medical services.