{"procedure":{"code_type":"CPT","code":"99461","lay_name":"Newborn care outside a hospital or birth center, first day","blurb":"Covers the first day of evaluation and management of a healthy newborn born somewhere other than a hospital or birthing center, such as at home or in an office, billed per day.","slug":"cpt-99461-newborn-care-outside-a-hospital-or-birth-center-first-day","description":"INIT E M NORM NB OTHER","name_source":"llm:claude-opus-5","name_reviewed":false,"ccs":{"code":"227","label":"Consultation, evaluation, and preventative care","surgery_flag":"n/a"}},"settings":{"outpatient":{"setting":"outpatient","computed_at":"2026-09-25T11:55:12.319193Z","corpus_loaded_through":"2026-09-25T01:10:45.071082Z","filing_date_min":"2023-11-06","filing_date_max":"2026-09-22","checked_from":"2026-09-05T02:23:05.982663Z","checked_through":"2026-09-25T01:10:45.071082Z","n_priced_setters":3956,"n_filed":235,"n_usable":226,"n_not_usable":0,"n_labelled":5,"n_no_cash":4,"n_estimated":0,"n_states":39,"cash_p10":45.5,"cash_p20":75.09,"cash_p25":87.85,"cash_p50":143.0,"cash_p75":208.2,"cash_p80":241.15,"cash_p90":281.0,"cash_mean_trimmed":151.04,"gross_p50":209.0,"cash_to_gross_p50":0.65,"medicare_rate":null,"medicare_schedule":null,"medicare_year":null,"cash_to_medicare_p50":null,"by_state":[{"state":"AK","n":6,"p20":null,"p50":null,"p80":null},{"state":"AL","n":2,"p20":null,"p50":null,"p80":null},{"state":"AR","n":2,"p20":null,"p50":null,"p80":null},{"state":"AZ","n":1,"p20":null,"p50":null,"p80":null},{"state":"CA","n":8,"p20":null,"p50":null,"p80":null},{"state":"CO","n":2,"p20":null,"p50":null,"p80":null},{"state":"FL","n":4,"p20":null,"p50":null,"p80":null},{"state":"HI","n":5,"p20":null,"p50":null,"p80":null},{"state":"IA","n":14,"p20":167.2,"p50":167.2,"p80":167.2},{"state":"IL","n":13,"p20":87.85,"p50":138.4,"p80":168.6},{"state":"IN","n":8,"p20":null,"p50":null,"p80":null},{"state":"KS","n":5,"p20":null,"p50":null,"p80":null},{"state":"KY","n":1,"p20":null,"p50":null,"p80":null},{"state":"LA","n":1,"p20":null,"p50":null,"p80":null},{"state":"ME","n":2,"p20":null,"p50":null,"p80":null},{"state":"MI","n":28,"p20":67.9,"p50":123.0,"p80":163.5},{"state":"MN","n":7,"p20":null,"p50":null,"p80":null},{"state":"MO","n":3,"p20":null,"p50":null,"p80":null},{"state":"MS","n":2,"p20":null,"p50":null,"p80":null},{"state":"MT","n":2,"p20":null,"p50":null,"p80":null},{"state":"ND","n":1,"p20":null,"p50":null,"p80":null},{"state":"NE","n":2,"p20":null,"p50":null,"p80":null},{"state":"NH","n":4,"p20":null,"p50":null,"p80":null},{"state":"NJ","n":1,"p20":null,"p50":null,"p80":null},{"state":"NV","n":4,"p20":null,"p50":null,"p80":null},{"state":"NY","n":27,"p20":162.0,"p50":281.0,"p80":999999999.0},{"state":"OH","n":6,"p20":null,"p50":null,"p80":null},{"state":"OK","n":10,"p20":122.5,"p50":122.5,"p80":122.5},{"state":"OR","n":1,"p20":null,"p50":null,"p80":null},{"state":"PA","n":10,"p20":32.11,"p50":38.87,"p80":43.94},{"state":"SC","n":3,"p20":null,"p50":null,"p80":null},{"state":"TN","n":6,"p20":null,"p50":null,"p80":null},{"state":"TX","n":3,"p20":null,"p50":null,"p80":null},{"state":"VA","n":3,"p20":null,"p50":null,"p80":null},{"state":"VT","n":3,"p20":null,"p50":null,"p80":null},{"state":"WA","n":2,"p20":null,"p50":null,"p80":null},{"state":"WI","n":19,"p20":134.34,"p50":241.15,"p80":241.15},{"state":"WV","n":1,"p20":null,"p50":null,"p80":null},{"state":"WY","n":4,"p20":null,"p50":null,"p80":null}],"by_segment":{"hospital_type":[{"key":"acute","n":156,"p20":75.09,"p50":134.34,"p80":230.25},{"key":"childrens","n":6,"p20":null,"p50":null,"p80":null},{"key":"critical_access","n":64,"p20":87.85,"p50":146.94,"p80":241.15}],"ownership":[{"key":"for_profit","n":16,"p20":null,"p50":null,"p80":null},{"key":"government","n":41,"p20":104.62,"p50":164.72,"p80":251.0},{"key":"nonprofit","n":169,"p20":75.09,"p50":147.47,"p80":241.15}],"affiliation":[{"key":"affiliated","n":177,"p20":69.5,"p50":134.34,"p80":225.0},{"key":"independent","n":49,"p20":95.2,"p50":166.4,"p80":266.0}]},"histogram":[{"lo":37.53,"hi":207.46,"n":158},{"lo":207.46,"hi":1146.84,"n":45},{"lo":1146.84,"hi":6339.65,"n":0},{"lo":6339.65,"hi":35045.09,"n":0},{"lo":35045.09,"hi":193726.61,"n":0},{"lo":193726.61,"hi":1070906.18,"n":0},{"lo":1070906.18,"hi":5919889.07,"n":0},{"lo":5919889.07,"hi":32724702.91,"n":0},{"lo":32724702.91,"hi":180899703.92,"n":0},{"lo":180899703.92,"hi":999999999.0,"n":12}],"previous":null},"inpatient":{"setting":"inpatient","computed_at":"2026-09-25T11:55:12.319193Z","corpus_loaded_through":"2026-09-25T01:10:45.071082Z","filing_date_min":"2023-11-06","filing_date_max":"2026-09-15","checked_from":"2026-09-05T02:23:05.982663Z","checked_through":"2026-09-25T01:10:45.071082Z","n_priced_setters":3956,"n_filed":136,"n_usable":129,"n_not_usable":0,"n_labelled":0,"n_no_cash":7,"n_estimated":0,"n_states":36,"cash_p10":62.37,"cash_p20":81.78,"cash_p25":87.85,"cash_p50":146.94,"cash_p75":202.0,"cash_p80":223.73,"cash_p90":241.15,"cash_mean_trimmed":143.68,"gross_p50":216.0,"cash_to_gross_p50":0.65,"medicare_rate":null,"medicare_schedule":null,"medicare_year":null,"cash_to_medicare_p50":null,"by_state":[{"state":"AK","n":1,"p20":null,"p50":null,"p80":null},{"state":"AL","n":2,"p20":null,"p50":null,"p80":null},{"state":"AR","n":1,"p20":null,"p50":null,"p80":null},{"state":"CA","n":1,"p20":null,"p50":null,"p80":null},{"state":"CO","n":1,"p20":null,"p50":null,"p80":null},{"state":"FL","n":1,"p20":null,"p50":null,"p80":null},{"state":"HI","n":4,"p20":null,"p50":null,"p80":null},{"state":"IA","n":11,"p20":167.2,"p50":167.2,"p80":167.2},{"state":"IL","n":10,"p20":87.85,"p50":99.4,"p80":168.6},{"state":"IN","n":8,"p20":null,"p50":null,"p80":null},{"state":"KS","n":1,"p20":null,"p50":null,"p80":null},{"state":"KY","n":1,"p20":null,"p50":null,"p80":null},{"state":"LA","n":1,"p20":null,"p50":null,"p80":null},{"state":"ME","n":1,"p20":null,"p50":null,"p80":null},{"state":"MI","n":13,"p20":60.0,"p50":87.2,"p80":241.15},{"state":"MN","n":4,"p20":null,"p50":null,"p80":null},{"state":"MO","n":2,"p20":null,"p50":null,"p80":null},{"state":"MS","n":1,"p20":null,"p50":null,"p80":null},{"state":"MT","n":2,"p20":null,"p50":null,"p80":null},{"state":"ND","n":1,"p20":null,"p50":null,"p80":null},{"state":"NH","n":4,"p20":null,"p50":null,"p80":null},{"state":"NJ","n":1,"p20":null,"p50":null,"p80":null},{"state":"NV","n":3,"p20":null,"p50":null,"p80":null},{"state":"NY","n":10,"p20":67.65,"p50":162.0,"p80":202.0},{"state":"OH","n":2,"p20":null,"p50":null,"p80":null},{"state":"OK","n":10,"p20":122.5,"p50":122.5,"p80":122.5},{"state":"OR","n":1,"p20":null,"p50":null,"p80":null},{"state":"PA","n":1,"p20":null,"p50":null,"p80":null},{"state":"SC","n":3,"p20":null,"p50":null,"p80":null},{"state":"TN","n":4,"p20":null,"p50":null,"p80":null},{"state":"TX","n":2,"p20":null,"p50":null,"p80":null},{"state":"VA","n":3,"p20":null,"p50":null,"p80":null},{"state":"VT","n":4,"p20":null,"p50":null,"p80":null},{"state":"WI","n":12,"p20":241.15,"p50":241.15,"p80":241.15},{"state":"WV","n":1,"p20":null,"p50":null,"p80":null},{"state":"WY","n":1,"p20":null,"p50":null,"p80":null}],"by_segment":{"hospital_type":[{"key":"acute","n":92,"p20":81.78,"p50":122.5,"p80":189.63},{"key":"childrens","n":2,"p20":null,"p50":null,"p80":null},{"key":"critical_access","n":35,"p20":79.2,"p50":172.9,"p80":241.15}],"ownership":[{"key":"for_profit","n":15,"p20":null,"p50":null,"p80":null},{"key":"government","n":19,"p20":null,"p50":null,"p80":null},{"key":"nonprofit","n":95,"p20":85.0,"p50":162.0,"p80":225.0}],"affiliation":[{"key":"affiliated","n":101,"p20":79.2,"p50":141.4,"p80":225.0},{"key":"independent","n":28,"p20":94.5,"p50":159.6,"p80":223.0}]},"histogram":[{"lo":59.45,"hi":68.9,"n":13},{"lo":68.9,"hi":79.86,"n":6},{"lo":79.86,"hi":92.55,"n":12},{"lo":92.55,"hi":107.27,"n":8},{"lo":107.27,"hi":124.33,"n":14},{"lo":124.33,"hi":144.09,"n":5},{"lo":144.09,"hi":167.0,"n":11},{"lo":167.0,"hi":193.56,"n":19},{"lo":193.56,"hi":224.33,"n":10},{"lo":224.33,"hi":260.0,"n":19}],"previous":null}},"related":[{"code_type":"CPT","code":"99283","lay_name":"Emergency room visit, level 3 of 5","slug":"cpt-99283-emergency-room-visit-level-3-of-5"},{"code_type":"CPT","code":"99284","lay_name":"Emergency room visit, level 4 of 5","slug":"cpt-99284-emergency-room-visit-level-4-of-5"},{"code_type":"CPT","code":"99282","lay_name":"Emergency room visit, level 2 of 5","slug":"cpt-99282-emergency-room-visit-level-2-of-5"},{"code_type":"CPT","code":"99285","lay_name":"Emergency room visit, highest level","slug":"cpt-99285-emergency-room-visit-highest-level"},{"code_type":"CPT","code":"99281","lay_name":"Emergency room visit, lowest level","slug":"cpt-99281-emergency-room-visit-lowest-level"},{"code_type":"CPT","code":"99291","lay_name":"Critical care, first 30 to 74 minutes","slug":"cpt-99291-critical-care-first-30-to-74-minutes"},{"code_type":"CPT","code":"99292","lay_name":"Critical care, each additional 30 minutes","slug":"cpt-99292-critical-care-each-additional-30-minutes"},{"code_type":"CPT","code":"99211","lay_name":"Brief office visit for an existing patient (level 1)","slug":"cpt-99211-brief-office-visit-for-an-existing-patient-level-1"},{"code_type":"CPT","code":"99213","lay_name":"Office visit for an existing patient, moderate level","slug":"cpt-99213-office-visit-for-an-existing-patient-moderate-level"},{"code_type":"CPT","code":"99212","lay_name":"Short office visit for an existing patient","slug":"cpt-99212-short-office-visit-for-an-existing-patient"},{"code_type":"CPT","code":"99214","lay_name":"Office visit, established patient, moderate complexity","slug":"cpt-99214-office-visit-established-patient-moderate-complexity"},{"code_type":"CPT","code":"99215","lay_name":"Office visit, established patient, high complexity","slug":"cpt-99215-office-visit-established-patient-high-complexity"}]}