# CPT 99285: Emergency department visit, high medical decision making

Medicare CPT 99285 pays $171.35 in a non-facility setting and $171.35 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $159.34 in Wisconsin to $232.36 in Alaska, a 46% spread.

Web page: https://www.med-reveal.com/rates/99285-cpt-fee-schedule
Section: Evaluation and Management
Billed by: Emergency Medicine, Evaluation, General Acute Care Hospital, Ophthalmology

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $171.35 |
| National facility | $171.35 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $232.36 | $232.36 |
| Florida | $186.60 | $186.60 |
| New York | $185.95 | $185.95 |
| Illinois | $185.69 | $185.69 |
| District of Columbia | $184.24 | $184.24 |
| New Jersey | $182.29 | $182.29 |
| Connecticut | $179.06 | $179.06 |
| Michigan | $176.56 | $176.56 |
| West Virginia | $175.41 | $175.41 |
| Massachusetts | $175.33 | $175.33 |
| Maryland | $175.25 | $175.25 |
| Washington | $175.21 | $175.21 |
| Georgia | $173.70 | $173.70 |
| Pennsylvania | $173.21 | $173.21 |
| Rhode Island | $172.87 | $172.87 |
| California | $172.77 | $172.77 |
| New Mexico | $172.77 | $172.77 |
| Puerto Rico | $171.34 | $171.34 |
| Virgin Islands | $171.34 | $171.34 |
| Montana | $171.31 | $171.31 |
| Colorado | $170.83 | $170.83 |
| Texas | $170.61 | $170.61 |
| New Hampshire | $170.23 | $170.23 |
| Louisiana | $170.22 | $170.22 |
| Delaware | $170.13 | $170.13 |
| Ohio | $169.59 | $169.59 |
| Missouri | $169.31 | $169.31 |
| Oregon | $169.15 | $169.15 |
| Nevada | $168.69 | $168.69 |
| Utah | $168.41 | $168.41 |
| Arizona | $168.36 | $168.36 |
| Hawaii | $167.57 | $167.57 |
| Kentucky | $167.57 | $167.57 |
| South Carolina | $167.29 | $167.29 |
| Wyoming | $167.18 | $167.18 |
| Virginia | $166.26 | $166.26 |
| Oklahoma | $165.45 | $165.45 |
| Maine | $164.40 | $164.40 |
| Mississippi | $164.14 | $164.14 |
| North Carolina | $164.10 | $164.10 |
| Vermont | $163.21 | $163.21 |
| Tennessee | $161.95 | $161.95 |
| North Dakota | $161.82 | $161.82 |
| Alabama | $161.67 | $161.67 |
| Indiana | $161.52 | $161.52 |
| Kansas | $161.31 | $161.31 |
| Idaho | $161.16 | $161.16 |
| South Dakota | $160.70 | $160.70 |
| Minnesota | $160.69 | $160.69 |
| Arkansas | $160.51 | $160.51 |
| Iowa | $159.83 | $159.83 |
| Nebraska | $159.70 | $159.70 |
| Wisconsin | $159.34 | $159.34 |

## Related codes

- 99281: Emergency department visit, minimal problem, may not require physician presence — https://www.med-reveal.com/rates/99281-cpt-fee-schedule
- 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

Commercial negotiated rates for 99285 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