How Much Does Subsequent Ic Vlbw Infless than 1,500 Gm Cost?
Also known as: Sbsq ic vlbw inf<1,500 gm (CPT 99478)
Daily intensive care for a very low birth weight infant (less than 1,500 grams / about 3.3 pounds) after the initial day.
Subsequent Ic Vlbw Infless than 1,500 Gm (CPT 99478) costs $116 at Medicare rates.
The rates shown below represent the complete Medicare reimbursement for this service. No separate facility fee applies for this type of procedure.
Patient Guide: Subsequent Ic Vlbw Infless than 1,500 Gm
What you need to know before your appointment
What to Expect
The NICU team provides specialized care for your very small premature baby, including temperature regulation, feeding support, breathing assistance, and growth monitoring.
How Long Does It Take?
Each subsequent day of intensive care
Common Reasons Doctors Order This
Ongoing NICU care for very low birth weight premature infant
How to Prepare
Visit and bond with your baby through kangaroo care when allowed. Pump breast milk regularly. Ask about developmental milestones.
Procedures Commonly Done Together
These procedures are frequently performed alongside Sbsq ic vlbw inf<1,500 gm
How to Reduce Your Cost for Sbsq ic vlbw inf<1,500 gm
Practical tips that can save you hundreds or thousands of dollars
- 1 Ask about cash-pay discounts
Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.
- 2 Compare facility vs. office setting costs
Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.
- 3 Shop around — costs vary significantly
Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.
How is the Price Calculated?
Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.
Payment = Total RVU (3.47) x CF ($33.40) = $116
Related Procedures
Similar procedures in the same category or body system
Frequently Asked Questions
How much does Sbsq ic vlbw inf<1,500 gm cost?
The Medicare facility rate for Sbsq ic vlbw inf<1,500 gm is $116. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).
How much does Sbsq ic vlbw inf<1,500 gm cost without insurance?
Without insurance, the cost of Sbsq ic vlbw inf<1,500 gm can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.
Does insurance cover Sbsq ic vlbw inf<1,500 gm?
Most commercial health insurance plans and Medicare cover Sbsq ic vlbw inf<1,500 gm when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.
Why does the cost vary so much by location?
Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.