99475 Pediatric critical care age 2-5 initial
Also known as: pediatric critical care age 2-5 initial, PICU preschool
Initial critical care evaluation and management of acutely ill or injured child age 2-5 years requiring intensive care unit level services.
In Plain Language
emergency intensive care for very sick preschool child
Clinical Context
Used for initial comprehensive critical care of children age 2-5 years with serious conditions requiring high-acuity monitoring and interventions in intensive care setting.
RVU Breakdown
| Work RVU | 11.25 |
| Total RVU | 11.25 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
E&M codes require documentation of medical decision-making (MDM) complexity or total time spent on the encounter. For 2026, time-based coding includes all physician time on the date of the encounter.
How This Code Compares
With a work RVU of 11.25, this code ranks in the 99th percentile among Evaluation & Management codes — 7.3x the median (1.54). The highest wRVU in this category is 18.46.
Specialties
Frequently Asked Questions
What is CPT code 99475?
CPT 99475 (Pediatric critical care age 2-5 initial) is a Evaluation & Management code. Initial critical care evaluation and management of acutely ill or injured child age 2-5 years requiring intensive care unit level services.
Who uses CPT code 99475?
CPT 99475 is used by Pediatrics, Critical Care. Used for initial comprehensive critical care of children age 2-5 years with serious conditions requiring high-acuity monitoring and interventions in intensive care setting.
When is CPT 99475 used?
Used for initial comprehensive critical care of children age 2-5 years with serious conditions requiring high-acuity monitoring and interventions in intensive care setting.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.