CPT 99478 Evaluation & Management
Sbsq ic vlbw inf<1,500 gm Cost
Body System: General
Medicare Facility Rate
$116
CMS PFS CY2026
Medicare Non-Facility Rate
$116
Office/clinic setting
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
2.75
Work RVU
0.55
Facility PE RVU
0.17
Malpractice RVU
3.47
Total RVU
Frequently Asked Questions
How much does Sbsq ic vlbw inf<1,500 gm cost?
The Medicare facility rate is $116. Commercial insurance typically pays 150-250% of Medicare rates (varies).
How much does Sbsq ic vlbw inf<1,500 gm 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 $116.