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See a sample rate comparisonCPT 99283 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 GC - Service performed by resident under supervision |
| Complexity Level | Low |
| Medicare Fee Schedule | $69.47 national non-facility rate (2026) · View Medicare rates for 99283 |
| Medicaid Fee Schedule | $56.50 median across 42 state programs · View Medicaid rates for 99283 |
National average reimbursement for CPT 99283 by major payers:
$90.49
$71.85
$77.44
$103.51
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CPT 99283
5 of 25 sample ratesHigher to lower in this preview
Nidhish Sasi
$256.85Published rateNkele Davis
$177.63Published rateHala Ashraf
$127.50Published rateJaime Lent
UPMC
$104.48Published rateMobile Wound Care LLC
$53.11Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 99283 vs. Other Emergency Department Services Codes
The CPT 99283 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 99283 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 99283. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99283 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 (Current Procedural Terminology) codes are a standardized set of five-digit codes used by healthcare providers to describe medical, surgical, and diagnostic services. They are essential for billing, processing insurance claims, and tracking medical procedures across the healthcare system.
To find the cost of a specific medical procedure, you will typically need the CPT code for that procedure and information about your geographic location. For detailed fee schedule lookups tailored to your specific situation, it is recommended to use a tool like Payerprice. Payerprice allows you to search with CPT codes and specific locations to get relevant pricing information.
You can search for healthcare fee schedules using specialized tools. For a comprehensive and specific search based on CPT codes and your location, Payerprice offers a fee schedule lookup tool. This allows you to find pricing information relevant to your particular needs, helping you understand potential costs for services in your area.
Healthcare pricing is complex due to a multitude of factors, including negotiations between providers and different insurance payers, varying service rates based on location and facility type, the inclusion of bundled services, and the distinction between billed charges, allowed amounts, and out-of-pocket costs. Tools like Payerprice aim to bring transparency to this complexity by providing access to fee schedule data.
Payerprice provides extensive data on fee schedules for a wide range of medical services identifiable by CPT codes. While it aims to be comprehensive, the exact coverage can vary, and users should check the tool for the specific CPT codes and locations they are interested in to confirm availability and relevance.
To use Payerprice, you typically need to input the CPT code for the medical service you are looking for, along with your specific geographic location. The tool will then provide relevant fee schedule information based on these inputs, helping you understand potential costs for services in your area.