CPT code 99281: ED visit, may not require physician presence2026 Medicare rate & RVUs in Arkansas

Reports a limited emergency department evaluation or management service that may be furnished without a physician or other qualified health care professional present.

CMS RVU26DEffective Oct 1, 2026One payment locality5.8K Medicare services in 2024

In Arkansas, Medicare pays $10.30 for 99281 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$10.30Hospital or facility

Check a contract rate as a % of Medicare · 99281 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 99281 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Arkansas
  2. What 99281 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 99281 covers

99281 is the lowest-level emergency department evaluation and management service. It covers an ED encounter whose care may not require a physician or other qualified health care professional to be physically present. It is specific to the emergency department setting; an office visit or an inpatient hospital service is not reported with this code. Triage by itself does not establish that an ED evaluation and management service was furnished.

Document the reason for the visit, the assessment or care provided, and why the encounter supports this level rather than a higher ED service. Unlike 99282–99285, 99281 is not distinguished by a stated medical decision-making level in its descriptor. On a Medicare physician claim, it is valued under the Physician Fee Schedule as a professional service; the hospital reports its facility services through the applicable facility payment system.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Arkansas compares for 99281

Across 109 of 109 payment localities, the facility rate for 99281 runs from $10.26 in Wisconsin to $14.86 in Alaska. Arkansas pays $10.30. The RVUs are the same everywhere; the geographic indexes change the dollars.

99281 in Arkansas vs other payment areas
  1. Arkansas · this page$10.30
  2. Los Angeles, CA · California$11.33+$1.03
  3. Washington, DC area · District of Columbia$11.88+$1.58
  4. Miami, FL · Florida$12.62+$2.32
  5. Chicago, IL · Illinois$12.39+$2.09
  6. Manhattan, NY · New York$12.41+$2.11
  7. Alaska · Alaska$14.86+$4.56

Other areas in Arkansas first, then benchmark localities. Bars start at $0.

Every other payment area

99281 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$10.38
ArizonaArizona—$10.83
Bakersfield, CACalifornia—$10.95
Chico, CACalifornia—$10.86
El Centro, CACalifornia—$10.86
Fresno, CACalifornia—$10.86
Hanford, CACalifornia—$10.86
Madera, CACalifornia—$10.86

99281 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
99281 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 99281 in every payment locality

How the 99281 rate is calculated

Each of 99281’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 99281

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.25

0.25 RVUs× 1.000 GPCI

Practice expense0.05

0.05 RVUs× 1.000 GPCI

Malpractice0.03

0.03 RVUs× 1.000 GPCI

Adjusted RVUs

0.3300

Conversion factor

$33.4009

Medicare rate

$11.02

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Arkansas inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,037

Code
99281
Physician work
0.25
Practice expense
0.05
Malpractice
0.03

GPCI2026.csv

7

Locality
Arkansas
Physician work
1.000
Practice expense
0.859
Malpractice
0.515
Facility calculation for 99281 in Arkansas
ComponentRVULocality factorAdjusted
Physician work0.25× 1.0000.2500
Practice expense0.05× 0.8590.0430
Malpractice0.03× 0.5150.0155
Total RVUs0.3084
Conversion factor× 33.4009

Facility rate, Arkansas$10.30

Facility: (0.25 × 1 + 0.05 × 0.859 + 0.03 × 0.515) × $33.4009 = $10.30

Open 99281 in the RVU calculator

Payment rules and modifiers for 99281

99281 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · 99281

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

99281 isn’t priced in this setting.

How 99281 has changed in Arkansas

99281 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$10.30RVU26D
2026-07-01Not available in this setting$10.30RVU26C
2026-04-01Not available in this setting$10.30RVU26B
2026-01-01Not available in this setting$10.30RVU26A
2025-10-01Not available in this setting$10.26RVU25D
2025-07-01Not available in this setting$10.26RVU25C
2025-04-01Not available in this setting$10.26RVU25B
2025-01-01Not available in this setting$10.26RVU25A
2024-10-01Not available in this setting$10.56RVU24D
2024-07-01Not available in this setting$10.56RVU24C
2024-04-01Not available in this setting$10.56RVU24B
2024-03-09Not available in this setting$10.56RVU24AR
2024-01-01Not available in this setting$10.38RVU24A
2023-10-01Not available in this setting$10.87RVU23D
2023-07-01Not available in this setting$10.87RVU23C
2023-04-01Not available in this setting$10.87RVU23B
2023-01-01Not available in this setting$10.87RVU23A
2022-10-01Not available in this setting$20.64RVU22D
2022-07-01Not available in this setting$20.64RVU22C
2022-04-01Not available in this setting$20.64RVU22B
2022-01-01Not available in this setting$20.64RVU22A
2021-10-01Not available in this setting$20.81RVU21D
2021-07-01Not available in this setting$20.81RVU21C
2021-04-01Not available in this setting$20.81RVU21B
2021-01-01Not available in this setting$20.81RVU21A
2020-10-01Not available in this setting$21.67RVU20D
2020-07-01Not available in this setting$21.67RVU20C
2020-04-01Not available in this setting$21.67RVU20B
2020-01-01Not available in this setting$21.67RVU20A
2019-10-01Not available in this setting$20.50RVU19D
2019-07-01Not available in this setting$20.50RVU19C
2019-04-01Not available in this setting$20.50RVU19B
2019-01-01Not available in this setting$20.50RVU19A
2018-10-01Not available in this setting$20.48RVU18D
2018-07-01Not available in this setting$20.48RVU18C
2018-04-01Not available in this setting$20.48RVU18B
2018-01-01Not available in this setting$20.48RVU18AR1
2017-10-01Not available in this setting$20.38RVU17D
2017-07-01Not available in this setting$20.38RVU17C
2017-04-01Not available in this setting$20.38RVU17B
2017-01-01Not available in this setting$20.38RVU17A
2016-10-01Not available in this setting$20.29RVU16D
2016-07-01Not available in this setting$20.29RVU16C
2016-04-01Not available in this setting$20.29RVU16B
2016-01-01Not available in this setting$20.29RVU16A
2015-10-01Not available in this setting$20.17RVU15D
2015-07-01Not available in this setting$20.17RVU15C
2015-04-01Not available in this setting$20.07RVU15B
2015-01-01Not available in this setting$20.07RVU15A
2014-10-01Not available in this setting$20.06RVU14D
2014-07-01Not available in this setting$20.06RVU14C
2014-04-01Not available in this setting$20.06RVU14B
2014-01-01Not available in this setting$20.06RVU14A
2013-10-01Not available in this setting$19.30RVU13D
2013-07-01Not available in this setting$19.30RVU13C
2013-04-01Not available in this setting$19.30RVU13B
2013-01-01Not available in this setting$19.30RVU13AR

Price 99281 for an earlier date of service

Where the Arkansas rate applies

Arkansas is a Medicare payment area, not a city. Our Census mapping connects it to 626 cities and communities in Arkansas. Some span more than one payment area; confirm with the service ZIP.

  • Acorn
  • Adona
  • Alexander
  • Alicia
  • Alix
  • Alleene
  • Allport
  • Alma

Browse all communities in Arkansas

99281 billing questions

How does 99281 differ from 99282?

99281 describes an ED service that may not require a physician or qualified health care professional to be present. 99282 is the next level and is selected using its applicable medical decision-making criteria.

Can triage alone support 99281?

No. Triage alone does not establish that an ED evaluation and management service was furnished; document the assessment or care provided during the encounter.

What documentation supports 99281?

Record the reason for the ED visit and the evaluation or management work actually performed. The note should support an ED service at this level rather than a higher-level service.

Is 99281 selected by time?

The encounter documentation should describe the service furnished rather than rely on elapsed time alone.

Does 99281 represent the hospital facility charge?

On a Medicare physician claim, 99281 represents the professional ED service. The hospital reports its facility services through the applicable facility payment system.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 99281PPRRVU2026_Oct_nonQPP.csv, line 13,037 (RVU26D)
Geographic factors for ArkansasGPCI2026.csv, line 7 (RVU26D)

Open CMS sourceHow we calculate rates

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