CPT 99461 Evaluation & Management
Init nb em per day non-fac Cost
Body System: General
Medicare Facility Rate
$53
CMS PFS CY2026
Medicare Non-Facility Rate
$94
Office/clinic setting
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
1.26
Work RVU
0.26
Facility PE RVU
0.07
Malpractice RVU
2.81
Total RVU
Frequently Asked Questions
How much does Init nb em per day non-fac cost?
The Medicare facility rate is $53. Commercial insurance typically pays 150-250% of Medicare rates (varies).
How much does Init nb em per day non-fac cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $53.