What factors influence CPT 99282 fee schedules?

Key factors include Medicare & Medicaid rates, private insurance negotiated rates, geographic location (urban vs. rural), and the type of provider (hospital vs. private practice).

What does CPT 99282 represent?

CPT 99282 represents an emergency department visit for evaluation and management requiring moderate medical decision-making, often involving multiple diagnoses or prescription management.

What is CPT Code 99282?

CPT Code 99282 is designated for emergency department visits that necessitate a medically appropriate history and/or examination and involve straightforward medical decision-making. This code is specifically applied to encounters requiring moderate-level medical decision-making, which frequently includes managing multiple diagnoses or prescribing medications.

How do CPT 99282 reimbursement rates vary?

Reimbursement rates for CPT 99282 can vary considerably due to several factors, including the specific insurance payer (such as United, Cigna, Aetna, or BCBS), the geographic location where services are rendered, and the type of healthcare provider (e.g., a hospital setting versus a private practice). For specific reimbursement information relevant to your situation, you can use a tool like Payerprice to look up fee schedules based on the CPT code and your specific location.

How does CPT 99282 compare to other emergency department codes?

CPT Code 99282 is categorized under Evaluation and Management services for Emergency Department Services. It signifies a moderate-complexity encounter, which means it involves more provider time and a moderate level of medical decision-making when compared to lower-level codes like 99281. Conversely, it represents a less complex encounter than higher-level codes such as 99284.

CPT 99282 Fee Schedule

Last Verified: July 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Emergency Department Visit For, Emergency Department Visit For The Evaluation And Management Of A Patient Which Requires These 3 Key Components An Expanded Problem Focused Historyan Expanded Problem Focused Examination And Medi

Key Fact	Detail
Service Type	New or Established Patient Emergency Department Services
Common Place of Service	23 - Emergency Room 22 - On Campus Outpatient Hospital
Common Modifiers	None 25 - Significant, separately identifiable E/M service same day U5
Complexity Level	Low
Medicare Fee Schedule	View Medicare rates for 99282

National average reimbursement for CPT 99282 by major payers:

$56.31

$42.76

$55.00

$62.87

Preview provider-level rates for...

For billing codeCPT 99282

Payer	Code	Rate	NPI	Tax ID	State	Specialty
United	99282	$143.47	1609801356 - SUPARNA CHAKRABORTY	752613493 - TEXAS HEALTH PHYSICIANS GROUP	TX	Internal Medicine Physician (207R00000X)
United	99282	$104.37	1164047346 - TUCKER MATTHEWS	581537752 - EMORY UNIVERSITY	GA	Emergency Medicine Physician (207P00000X)
United	99282	$63.63	1285827634 - MICHAEL MCGRATH	593140335 - BAYCARE MEDICAL GROUP INC	FL	Emergency Medicine Physician (207P00000X)
United	99282	$107.15	1366974784 - ERASMO ESPINO	922417967	GA	Emergency Medicine Physician (207P00000X)
United	99282	$40.70	1811458177 - WOLINSKY PRIMARY CARE, PA	834172038 - (NC) WOLINSKY PRIMARY CARE PA	NC	Multi-Specialty Group (193200000X)
United	99282	$52.88	1235575697 - ARIEL VINAS	741586031	TX	Cardiovascular Disease Physician (207RC0000X)
United	99282	$73.87	1154563583 - DANIEL WOOD	581537752 - EMORY UNIVERSITY	GA	Emergency Medicine Physician (207P00000X)
United	99282	$104.37	1992719595 - TAMMIE QUEST	581537752 - EMORY UNIVERSITY	GA	Emergency Medicine Physician (207P00000X)
United	99282	$73.87	1043835093 - KATELYN PELOZA	204700877	GA	Emergency Medicine Physician (207P00000X)
United	99282	$66.48	1538509336 - DAVID WEINBERG	590714812 - LEE MEMORIAL HEALTH SYSTEM	FL	Emergency Medicine Physician (207P00000X)
United	99282	$67.06	1003310277 - NICHOLAS WALTER	10238552 - MAINEHEALTH	ME	Emergency Medicine Physician (207P00000X)
United	99282	$75.76	1215906326 - JOEL QUINONES	580566121 - (GA) JOHN D ARCHBOLD MEMORIAL HOSPITAL INC	GA	Emergency Medicine Physician (207P00000X)
United	99282	$102.58	1528555026 - NICOLE GUILLEN	931329784 - SAMARITAN PACIFIC HEALTH SERVICES INC	CA	Emergency Medicine Physician (207P00000X)
United	99282	$132.72	1245219542 - MAURICE CHAO	462439952 - (FL) BREVARD PHYSICIAN ASSOCIATES, PLLC	FL	Emergency Medicine Physician (207P00000X)
United	99282	$76.20	1669559233 - JOHN MISDARY	460360899 - MONUMENT HEALTH NETWORK INC	FL	Emergency Medicine Physician (207P00000X)
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist

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CPT 99282 vs. Other Emergency Department Services Codes

The CPT 99282 code is part of the New or Established Patient services used for Emergency Department Services. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 99282 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

Code	Complexity	Description
99281-CPT	Low	Emergency Department Visit For, Emergency Department Visit For The Evaluation And Management Of A Patient Which Requires These 3 Key Components A Problem Focused History A Problemfocused Examination And Straightforward Medical
99282-CPT	Low	Emergency Department Visit For, Emergency Department Visit For The Evaluation And Management Of A Patient Which Requires These 3 Key Components An Expanded Problem Focused Historyan Expanded Problem Focused Examination And Medi
99283-CPT	Low	Emergency Department Visit For, Emergency Department Visit For The Evaluation And Management Of A Patient Which Requires These 3 Key Components An Expanded Problem Focused Historyan Expanded Problem Focused Examination And Medi
99284-CPT	Moderate	Emergency Department Visit For, Emergency Department Visit For The Evaluation And Management Of A Patient Which Requires These 3 Key Components A Detailed History A Detailed Examination And Medical Decision Making Of Moderate Co

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99282. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 99282 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules

Medicare & Medicaid Rates

Government-set reimbursement amounts

Private Insurance Rates

Negotiated rates between providers and insurance companies

Geographic Location

Costs may be higher in urban areas.

Provider Type

Hospital providers may have different rates than private practice.

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