CPT code 99282: ED visit, straightforward MDM2026 Medicare rate & RVUs

Medicare pays $40.42 for 99282 nationally in a facility.

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

What 99282 covers

This code describes a physician or other qualified health care professional’s evaluation and management of a patient in the emergency department, with straightforward medical decision making. It fits a limited, low-complexity encounter, such as assessment of a minor, uncomplicated complaint when the clinical evaluation and plan remain simple. The service is commonly furnished in a hospital emergency department; the clinician’s work is distinct from the hospital’s facility services.

Choose the level from medical decision making, not elapsed time. Documentation should show the problems evaluated, relevant data reviewed or analyzed, and the management risk so the documented decision making supports the level reported. CMS values the professional service through physician fee schedule work, practice expense, and malpractice RVUs. Report 99282 for the ED professional evaluation and management service, not as a substitute for an office visit or an inpatient hospital service.

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.

Where 99282 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

99282 rates by state

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

How the 99282 rate is calculated

Each of 99282’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.

Payment rules and modifiers for 99282

99282 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.

99282 compared with similar codes

How to choose

99281ED visitMay not require physician presence

99281 covers an ED service that may not require a physician or other qualified health care professional. For 99282, the clinician provides the ED evaluation and the documented decision making is straightforward.

99283Emergency department visitLow medical decision making

99282 is for straightforward medical decision making; 99283 requires documentation supporting low medical decision making.

99284Emergency department visitModerate medical decision making

Use 99284 when the encounter supports moderate medical decision making. A straightforward encounter supports 99282 instead.

Codes related to 99282

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates