# CPT 99281: Emergency department visit, minimal problem, may not require physician presence

Medicare CPT 99281 pays $11.02 in a non-facility setting and $11.02 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $10.26 in Wisconsin to $14.86 in Alaska, a 45% spread.

Web page: https://www.med-reveal.com/rates/99281-cpt-fee-schedule
Section: Evaluation and Management
Billed by: Emergency Medicine, Evaluation, General Acute Care Hospital, Ophthalmology

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $11.02 |
| National facility | $11.02 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $14.86 | $14.86 |
| Florida | $11.97 | $11.97 |
| New York | $11.97 | $11.97 |
| Illinois | $11.91 | $11.91 |
| District of Columbia | $11.88 | $11.88 |
| New Jersey | $11.75 | $11.75 |
| Connecticut | $11.53 | $11.53 |
| Michigan | $11.33 | $11.33 |
| Massachusetts | $11.31 | $11.31 |
| Washington | $11.31 | $11.31 |
| Maryland | $11.28 | $11.28 |
| West Virginia | $11.24 | $11.24 |
| California | $11.17 | $11.17 |
| Georgia | $11.16 | $11.16 |
| Pennsylvania | $11.13 | $11.13 |
| Rhode Island | $11.13 | $11.13 |
| New Mexico | $11.09 | $11.09 |
| Puerto Rico | $11.03 | $11.03 |
| Virgin Islands | $11.03 | $11.03 |
| Montana | $11.02 | $11.02 |
| Colorado | $11.01 | $11.01 |
| New Hampshire | $10.97 | $10.97 |
| Texas | $10.97 | $10.97 |
| Delaware | $10.94 | $10.94 |
| Louisiana | $10.93 | $10.93 |
| Oregon | $10.90 | $10.90 |
| Ohio | $10.89 | $10.89 |
| Missouri | $10.87 | $10.87 |
| Nevada | $10.86 | $10.86 |
| Arizona | $10.83 | $10.83 |
| Hawaii | $10.83 | $10.83 |
| Utah | $10.82 | $10.82 |
| Wyoming | $10.76 | $10.76 |
| Kentucky | $10.75 | $10.75 |
| South Carolina | $10.75 | $10.75 |
| Virginia | $10.70 | $10.70 |
| Oklahoma | $10.62 | $10.62 |
| Maine | $10.58 | $10.58 |
| North Carolina | $10.55 | $10.55 |
| Mississippi | $10.53 | $10.53 |
| Vermont | $10.51 | $10.51 |
| North Dakota | $10.43 | $10.43 |
| Tennessee | $10.41 | $10.41 |
| Indiana | $10.39 | $10.39 |
| Alabama | $10.38 | $10.38 |
| Minnesota | $10.37 | $10.37 |
| Idaho | $10.36 | $10.36 |
| Kansas | $10.36 | $10.36 |
| South Dakota | $10.36 | $10.36 |
| Arkansas | $10.30 | $10.30 |
| Iowa | $10.28 | $10.28 |
| Nebraska | $10.27 | $10.27 |
| Wisconsin | $10.26 | $10.26 |

## Related codes

- 99282: Emergency department visit, straightforward medical decision making — https://www.med-reveal.com/rates/99282-cpt-fee-schedule
- 99283: Emergency department visit, low medical decision making — https://www.med-reveal.com/rates/99283-cpt-fee-schedule
- 99284: Emergency department visit, moderate medical decision making — https://www.med-reveal.com/rates/99284-cpt-fee-schedule
- 99285: Emergency department visit, high medical decision making — https://www.med-reveal.com/rates/99285-cpt-fee-schedule

Commercial negotiated rates for 99281 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules