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See a sample rate comparisonCPT 99282 Fee Schedule
Last Verified: October 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 | Evaluation and Management Emergency Department Services |
| Common Place of Service | 23 - Emergency Room 22 - On Campus Outpatient Hospital |
| Common Modifiers | 25 - Significant, separately identifiable E/M service same day U5 |
| Complexity Level | Low |
| Medicare Fee Schedule | $40.42 national non-facility rate (2026) · View Medicare rates for 99282 |
| Medicaid Fee Schedule | $32.23 median of the 8 states in the free preview · View Medicaid rates for 99282 |
National average reimbursement for CPT 99282 by major payers:
$56.31
$42.76
$55.00
$62.87
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CPT 99282
5 of 25 sample ratesHigher to lower in this preview
Suparna Chakraborty
Texas Health Physicians Group
$143.47Published rateNicole Guillen
Samaritan Pacific Health Services Inc
$102.58Published rateKatelyn Peloza
$73.87Published rateMichael Mcgrath
Baycare Medical Group Inc
$63.63Published rateJohn Rush
Active Life Health Of Garden City Medical PLLC
$37.72Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 99282 vs. Other Emergency Department Services Codes
The CPT 99282 code is part of the Evaluation and Management 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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Frequently Asked Questions
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.
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.
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.