How much does Medicare pay for CPT 99282?

Medicare allowed an average of $38.94 per service and paid $27.99 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $215.11, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 99282?

Emergency department visit with straightforward medical decision making. It was billed 44,380 times to 41,632 Medicare beneficiaries by 2,016 providers in 2024.

Does 99282 pay differently in an office than a hospital?

Yes. The allowed amount averaged $38.94 in an office setting and $38.94 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 99282 most?

Emergency Medicine, with 21,389 services from 1,075 clinicians. Next are Physician Assistant, Nurse Practitioner, Family Practice.

CPT 99282

Emergency department visit with straightforward medical decision making

$38.94Medicare-allowed amount per service, averaged across 44,380 services

Providers submitted

$215.11

Asking price, not received

Medicare allowed

$38.94

The fee schedule figure

Medicare paid

$27.99

Balance is patient coinsurance

Providers submitted an average of $215.11 for this code and Medicare allowed $38.94 — 5.5× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $27.99 (72%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $38.94
Hospital / facility: $38.94

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 28 services were billed in an office setting and 44,352 in a facility.

Services: 44,380
Beneficiaries: 41,632
Providers billing it: 2,016
Total allowed: $1,728,157

What Medicare pays for CPT 99282

Across 44,380 services billed by 2,016 providers to 41,632 beneficiaries, Medicare allowed an average of $38.94 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 99282

Specialty	Services	Beneficiaries	Avg allowed	Providers
Emergency Medicine	21,389	20,418	$40.37	1,075
Physician Assistant	6,584	6,265	$35.49	314
Nurse Practitioner	6,190	5,772	$34.48	247
Family Practice	4,412	4,074	$39.58	166
Internal Medicine	2,432	2,030	$41.31	59
Psychiatry	939	718	$42.31	37
General Surgery	510	502	$42.60	25
General Practice	291	281	$39.81	11
Hospitalist	274	261	$39.85	8
Cardiology	212	200	$42.54	8
Neurology	208	208	$42.92	15
Gastroenterology	132	128	$42.73	7
Anesthesiology	112	112	$42.72	5
Nephrology	90	69	$45.45	3
Interventional Cardiology	81	77	$43.14	4

99282 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New York	3,371	$41.55	$28.34	163
Connecticut	2,546	$41.18	$24.60	44
California	2,041	$40.28	$28.38	88
Arkansas	1,960	$37.19	$28.53	71
Oklahoma	1,937	$38.50	$28.78	89
Arizona	1,888	$36.97	$26.99	69
Illinois	1,804	$40.75	$28.20	73
Florida	1,785	$40.23	$28.84	103
South Carolina	1,684	$38.89	$28.87	95
Missouri	1,649	$37.92	$28.02	78
New Jersey	1,462	$40.89	$28.70	72
Pennsylvania	1,419	$38.96	$28.31	91
Mississippi	1,291	$36.88	$26.90	45
New Mexico	1,272	$37.77	$27.11	43
Kansas	1,225	$36.49	$28.24	45
Michigan	1,127	$39.93	$28.02	62
Ohio	1,089	$38.41	$27.00	58
Texas	1,088	$39.75	$28.68	63
Maryland	955	$40.27	$27.70	46
Oregon	931	$37.67	$27.21	39
Nebraska	757	$36.31	$28.40	34
Indiana	750	$39.51	$29.20	28
North Carolina	726	$37.10	$28.21	40
Minnesota	696	$37.24	$28.36	27
Tennessee	593	$38.00	$29.16	32
Colorado	561	$37.29	$27.87	25
Maine	559	$37.85	$27.36	27
Massachusetts	555	$38.55	$27.62	31
West Virginia	536	$40.84	$28.08	35
Wisconsin	514	$38.01	$28.28	30
Kentucky	498	$37.80	$28.54	21
Louisiana	439	$38.02	$27.43	18
Montana	431	$38.86	$27.38	19
Virginia	427	$38.18	$29.26	28
Washington	405	$36.96	$26.99	19
Georgia	381	$37.78	$28.36	21
South Dakota	338	$35.76	$26.44	15
Iowa	296	$36.57	$27.46	15
Wyoming	294	$38.13	$26.91	14
Alabama	268	$37.63	$28.53	18
Utah	204	$39.11	$29.37	12
Northern Mariana Islands	189	$35.40	$25.71	6
District of Columbia	180	$38.33	$26.32	9
U.S. Virgin Islands	174	$38.37	$28.04	3
Idaho	172	$35.99	$25.78	6
New Hampshire	139	$43.23	$30.20	5
Nevada	136	$40.11	$28.07	5
Vermont	122	$38.26	$27.73	7
Alaska	101	$47.86	$24.30	7
Delaware	91	$39.01	$27.83	5
Guam	80	$41.03	$29.14	3
Puerto Rico	71	$39.41	$30.49	2
Rhode Island	67	$39.12	$28.19	5
North Dakota	58	$38.82	$28.92	4
Hawaii	30	$36.05	$26.90	2
AA	18	$55.31	$32.25	1

Related codes

99214Established patient office or other outpatient visit$117.48
99213Established patient office or other outpatient visit$83.92
99232Subsequent hospital care$76.07
99233Subsequent hospital care$115.58
99215Established patient office or other outpatient visit$163.65
99204New patient office or other outpatient visit$157.90
99223Initial hospital care$167.67
99285Emergency department visit$169.68
99203New patient office or other outpatient visit$104.03
99212Established patient office or other outpatient visit$52.42
99291Critical care$208.35
99222Initial hospital care$126.29

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.