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CPT code 99292: Critical care, each additional 30 minutes2026 Medicare rate & RVUs in Washington, DC area

Report 99292 with 99291 when a physician or qualified health care professional provides enough additional critical care time for a critically ill patient.

CMS RVU26DEffective Oct 1, 2026One payment locality406K Medicare services in 2024

In Washington, DC area, Medicare pays $147.96 for 99292 in the office and $108.22 when it’s performed in a hospital or facility.

$147.96Office (non-facility)
$108.22Hospital or facility
+10.5%vs the national office rate ($133.94)

Check a contract rate as a % of Medicare · 99292 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 99292 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 99292 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 99292 covers

Code 99292 represents additional time spent managing a critically ill or injured patient whose condition creates a high risk of imminent, life-threatening deterioration. A physician or qualified health care professional may provide this care in settings such as an intensive care unit or emergency department; the patient’s acuity and the services furnished, not the unit’s name, support critical care. The work involves focused assessment and management of life-threatening organ-system problems, rather than routine monitoring or a high-complexity visit alone.

Report 99292 only with 99291, when documented critical care time meets the threshold for an additional unit: generally 75–104 minutes total for one unit, with another unit for each additional qualifying interval. Document the patient’s critical condition, the critical care services, and the total time for the date, excluding time spent on separately reportable procedures. CMS treats 99292 as an add-on code billed with a primary service and paid within that service’s global period.

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 99292

Across 109 of 109 payment localities, the office rate for 99292 runs from $123.01 in Arkansas to $171.39 in Alaska. Washington, DC area pays $147.96. The RVUs are the same everywhere; the geographic indexes change the dollars.

99292 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$147.96
  2. Los Angeles, CA · California$143.79−$4.17
  3. Miami, FL · Florida$147.78−$0.18
  4. Chicago, IL · Illinois$144.67−$3.29
  5. Manhattan, NY · New York$151.53+$3.57
  6. Alaska · Alaska$171.39+$23.43
  7. Alabama · Alabama$124.22−$23.74

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

99292 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$123.01$94.03
ArizonaArizona$131.25$98.56
Bakersfield, CACalifornia$137.27$100.29
Chico, CACalifornia$136.56$99.58
El Centro, CACalifornia$136.59$99.62
Fresno, CACalifornia$136.56$99.58
Hanford, CACalifornia$136.56$99.58
Madera, CACalifornia$136.56$99.58

99292 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$123.01

$171.39

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
99292 office rate range by state
State / territoryOffice rate rangeLocalities
AK$171.391
AL$124.221
AR$123.011
AZ$131.251
CA$136.56–$161.2329
CO$136.431
CT$140.991
DC$147.961
DE$132.921
FL$135.55–$147.783
GA$129.89–$136.522
GU$137.701
HI$137.701
IA$124.961
ID$125.801
IL$133.82–$144.674
IN$126.261
KS$125.221
KY$127.611
LA$127.74–$131.972
MA$136.29–$146.092
MD$134.67–$147.963
ME$126.95–$130.642
MI$130.48–$137.422
MN$130.011
MO$126.69–$131.503
MS$124.831
MT$133.921
NC$127.741
ND$129.371
NE$125.221
NH$135.071
NJ$142.39–$147.372
NM$131.241
NV$132.711
NY$129.10–$154.995
OH$129.551
OK$126.761
OR$131.45–$138.852
PA$129.32–$138.872
PR$134.381
RI$136.221
SC$128.901
SD$128.841
TN$125.731
TX$128.79–$137.078
UT$130.091
VA$130.81–$147.962
VI$134.381
VT$129.631
WA$135.79–$147.892
WI$126.481
WV$130.551
WY$131.941

See 99292 in every payment locality

How the 99292 rate is calculated

Each of 99292’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 · 99292

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.25

2.25 RVUs× 1.000 GPCI

Practice expense1.53

1.53 RVUs× 1.000 GPCI

Malpractice0.23

0.23 RVUs× 1.000 GPCI

Adjusted RVUs

4.0100

Conversion factor

$33.4009

Medicare rate

$133.94

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,044

Code
99292
Physician work
2.25
Practice expense
1.53
Malpractice
0.23

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 99292 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work2.25× 1.0542.3715
Practice expense1.53× 1.1781.8023
Malpractice0.23× 1.1130.2560
Total RVUs4.4298
Conversion factor× 33.4009

Office rate, Washington, DC area$147.96

Office: (2.25 × 1.054 + 1.53 × 1.178 + 0.23 × 1.113) × $33.4009 = $147.96

Facility: (2.25 × 1.054 + 0.52 × 1.178 + 0.23 × 1.113) × $33.4009 = $108.22

Open 99292 in the RVU calculator

Payment rules and modifiers for 99292

The CMS indicators that decide how 99292 is paid alongside other services.

CMS payment indicators · 99292

Critical care, each additional 30 minutes

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

Codes related to 99292

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

Codes related to 99292
CodeHow it relatesOffice range, Washington, DC area
Add-on codes
99291Critical care, initial service, at least 30 minutesPrimary critical care service required when reporting 99292.$344.32
Used instead
99285ED visit, high complexity decision makingHigh-level emergency department evaluation when critical care criteria are not met.No office rate
99223Initial hospital visit, high decision making or 75 minutesInitial hospital or observation evaluation when critical care is not supported.No office rate

How 99292 has changed in Washington, DC area

99292 · Office / nonfacility

$147.96

Effective 2026-10-01

The base rate is $20.30 higher than on 2025-10-01, moving from $127.66 to $147.96 (15.9%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

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

  1. January 1, 2026

    RVU26A

    $127.66changed to$147.96

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.11 changed to 1.53
    • Malpractice RVU 0.21 changed to 0.23
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $131.75changed to$127.66

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.10 changed to 1.11
    • Malpractice RVU 0.23 changed to 0.21

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $129.60changed to$131.75

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $134.12changed to$129.60

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.08 changed to 1.10
    • Malpractice RVU 0.22 changed to 0.23
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $138.52changed to$134.12

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.10 changed to 1.08
    • Malpractice RVU 0.21 changed to 0.22
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $139.24changed to$138.52

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.09 changed to 1.10

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $140.25changed to$139.24

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.03 changed to 1.09
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $137.69changed to$140.25

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.01 changed to 1.03
    • Malpractice RVU 0.20 changed to 0.21
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $137.97changed to$137.69

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.02 changed to 1.01

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $137.86changed to$137.97

    • Conversion factor 35.8887 changed to 35.9996
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $137.38changed to$137.86

    • Conversion factor 35.8043 changed to 35.8887
    • Malpractice RVU 0.19 changed to 0.20
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $137.88changed to$137.38

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $137.19changed to$137.88

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $135.89changed to$137.19

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.17 changed to 0.19
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $132.87changed to$135.89

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.12 changed to 1.02
    • Malpractice RVU 0.18 changed to 0.17
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $132.87

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$147.96$108.22RVU26D
2026-07-01$147.96$108.22RVU26C
2026-04-01$147.96$108.22RVU26B
2026-01-01$147.96$108.22RVU26A
2025-10-01$127.66$112.62RVU25D
2025-07-01$127.66$112.62RVU25C
2025-04-01$127.66$112.62RVU25B
2025-01-01$127.66$112.62RVU25A
2024-10-01$131.75$115.88RVU24D
2024-07-01$131.75$115.88RVU24C
2024-04-01$131.75$115.88RVU24B
2024-03-09$131.75$115.88RVU24AR
2024-01-01$129.60$113.99RVU24A
2023-10-01$134.12$118.49RVU23D
2023-07-01$134.12$118.49RVU23C
2023-04-01$134.12$118.49RVU23B
2023-01-01$134.12$118.49RVU23A
2022-10-01$138.52$122.27RVU22D
2022-07-01$138.52$122.27RVU22C
2022-04-01$138.52$122.27RVU22B
2022-01-01$138.52$122.27RVU22A
2021-10-01$139.24$123.28RVU21D
2021-07-01$139.24$123.28RVU21C
2021-04-01$139.24$123.28RVU21B
2021-01-01$139.24$123.28RVU21A
2020-10-01$140.25$125.70RVU20D
2020-07-01$140.25$125.70RVU20C
2020-04-01$140.25$125.70RVU20B
2020-01-01$140.25$125.70RVU20A
2019-10-01$137.69$124.22RVU19D
2019-07-01$137.69$124.22RVU19C
2019-04-01$137.69$124.22RVU19B
2019-01-01$137.69$124.22RVU19A
2018-10-01$137.97$124.52RVU18D
2018-07-01$137.97$124.52RVU18C
2018-04-01$137.97$124.52RVU18B
2018-01-01$137.97$124.52RVU18AR1
2017-10-01$137.86$124.89RVU17D
2017-07-01$137.86$124.89RVU17C
2017-04-01$137.86$124.89RVU17B
2017-01-01$137.86$124.89RVU17A
2016-10-01$137.38$124.44RVU16D
2016-07-01$137.38$124.44RVU16C
2016-04-01$137.38$124.44RVU16B
2016-01-01$137.38$124.44RVU16A
2015-10-01$137.88$124.89RVU15D
2015-07-01$137.88$124.89RVU15C
2015-04-01$137.19$124.27RVU15B
2015-01-01$137.19$124.27RVU15A
2014-10-01$135.89$122.97RVU14D
2014-07-01$135.89$122.97RVU14C
2014-04-01$135.89$122.97RVU14B
2014-01-01$135.89$122.97RVU14A
2013-10-01$132.87$119.42RVU13D
2013-07-01$132.87$119.42RVU13C
2013-04-01$132.87$119.42RVU13B
2013-01-01$132.87$119.42RVU13AR

Price 99292 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

99292 billing questions

When is 99292 reported with 99291?

Report 99292 for qualifying critical care time beyond the time represented by 99291. One unit generally applies at 75–104 total minutes; additional units require additional qualifying time.

Can 99292 be billed by itself?

No. It is an add-on code and must be reported with 99291 as the primary critical care service.

Does the patient have to be in an ICU?

No. Critical care may be furnished in an emergency department or another setting; the patient’s life-threatening condition and the services provided support the code.

What time should the record support?

Document total critical care time for the date, the patient’s critical condition, and the management performed. Do not include time spent on separately reportable procedures.

How is 99292 different from a high-level emergency visit?

99292 is additional time for critical care reported with 99291. A high-level emergency department evaluation code describes an ED visit that does not meet critical care criteria.

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 99292PPRRVU2026_Oct_nonQPP.csv, line 13,044 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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