Same day nb discharge
Newborn same-day evaluation and discharge costs range from $95.33 at Medicare rates to $128.87 in hospital outpatient settings, making it essential to verify your facility's actual charges before payment.
About the analyst
Priya Iyengar leads the billing code review team at BillRazor Research. She analyzes NCCI bundling edits, DRG coding, and regional rate variation. Expertise: NCCI bundling, DRG analysis, regional pricing.
Code 99463 covers the medical evaluation and management services provided to a newborn who is admitted and discharged from the hospital on the same calendar day. This applies to healthy newborns who require minimal medical intervention and can be safely released within 24 hours of birth. The Medicare benchmark is $957, though actual charges can vary significantly between facilities and insurance plans.
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Facility rate
$95
National Medicare benchmark
Non-facility rate
$99
Office setting benchmark
Data sources
3
23 data points
Key insights for CPT 99463
Facility vs office setting
$4 differenceFacility setting is less expensive for this procedure
What this procedure costs across different settings
The same procedure can cost very different amounts depending on where it's performed. These are the Medicare-allowed amounts — what hospitals actually charge can be 3-10x higher.
| Setting | Medicare rate | vs lowest |
|---|---|---|
| Facility (physician office) | $95 | Lowest |
| Non-facility (office) | $99 | +4% |
| Outpatient (APC) | $129 | +35% |
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About this data
Rates shown are from the 2026 Medicare Physician Fee Schedule, Hospital Outpatient Prospective Payment System (OPPS), Ambulatory Surgery Center Payment System, Clinical Laboratory Fee Schedule, Durable Medical Equipment Fee Schedule, and CMS Inpatient Prospective Payment System (DRG weights). Regional adjustments use CMS Geographic Practice Cost Indices (GPCI). Hospital charges are from CMS Hospital Price Transparency machine-readable files. All data is publicly available under federal law (45 CFR Part 180).
This data is for informational purposes only and does not constitute medical or financial advice. Actual costs depend on insurance coverage, negotiated rates, and individual circumstances.
Related procedures
Related pricing data
Data: Federal physician fee schedules, hospital payment data, surgery center rates, lab fee schedules, and drug pricing data. FY 2024. All publicly available from federal sources.
Methodology: Facility rate applies when the procedure is performed in a hospital or ASC. Non-facility rate applies in a physician office. GPCI adjustments reflect regional cost-of-living differences.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use