99478 Sbsq ic vlbw inf<1,500 gm
Also known as: VLBW day hospital care, very low birth weight
Subsequent day hospital care of very low birth weight newborn (less than 1,500 grams) per calendar day with continuing assessment and interventions.
In Plain Language
continued care of extremely premature baby in day hospital
Clinical Context
Used for ongoing day hospital management of extremely premature infants weighing less than 1,500 grams requiring observation and frequent monitoring.
RVU Breakdown
| Work RVU | 2.75 |
| Total RVU | 2.75 |
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 2.75, this code ranks in the 82nd percentile among Evaluation & Management codes — 1.8x the median (1.54). The highest wRVU in this category is 18.46.
Specialties
Frequently Asked Questions
What is CPT code 99478?
CPT 99478 (Sbsq ic vlbw inf<1,500 gm) is a Evaluation & Management code. Subsequent day hospital care of very low birth weight newborn (less than 1,500 grams) per calendar day with continuing assessment and interventions.
Who uses CPT code 99478?
CPT 99478 is used by Neonatology, Pediatrics. Used for ongoing day hospital management of extremely premature infants weighing less than 1,500 grams requiring observation and frequent monitoring.
When is CPT 99478 used?
Used for ongoing day hospital management of extremely premature infants weighing less than 1,500 grams requiring observation and frequent monitoring.
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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.