CPT code 99283: Emergency department visit, low medical decision making2026 Medicare rate & RVUs in Washington, DC area

In Washington, DC area, Medicare pays $74.78 for 99283 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 99283 nationwide

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

What 99283 covers

An emergency physician, nurse practitioner, or physician assistant evaluates and manages the patient in an organized hospital emergency department available for unscheduled care around the clock. An uncomplicated sprain, a stable chronic illness, or two self-limited problems can contribute to low problem complexity, but the presenting problem alone does not establish the visit level. The clinician's assessment, diagnostic decisions, and treatment plan determine the documented medical decision making.

Select 99283 when at least two of the three medical decision-making elements—problems, data, and management risk—meet or exceed the low level. Limited data can be supported by two unique tests ordered or reviewed, or by an assessment requiring an independent historian. Total time and new-versus-established status do not select the ED level. Document the problems addressed, relevant data, and management decisions. A laceration repair may be reported separately; append modifier 25 to 99283 only when the ED evaluation is significant and separately identifiable from the usual assessment for the repair. The hospital's facility service is billed separately from the clinician's professional visit.

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 Washington, DC area compares for 99283

Across 109 of 109 payment localities, the facility rate for 99283 runs from $64.46 in Wisconsin to $93.80 in Alaska. Washington, DC area pays $74.78. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

99283 rates by state

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

See 99283 in every payment locality

How the 99283 rate is calculated

Each of 99283’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 99283

99283 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.

Codes related to 99283

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

How 99283 has changed in Washington, DC area

Price 99283 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

• Washington

Browse all communities in District of Columbia

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