CPT code 99292: Critical care, each additional 30 minutes2026 Medicare rate & RVUs in North Carolina

In North Carolina, Medicare pays $127.74 for 99292 in the office and $96.27 when it’s performed in a hospital or facility.

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.

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 North Carolina 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. North Carolina pays $127.74. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

99292 rates by state

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

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.

Payment rules and modifiers for 99292

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

Codes related to 99292

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

How 99292 has changed in North Carolina

Price 99292 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

• Aberdeen
• Advance
• Ahoskie
• Alamance
• Albemarle
• Alexis
• Alliance
• Altamahaw

Browse all communities in North Carolina

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