# CPT 99291: Critical care, evaluation and management of the critically ill or injured patient, first 30-74 minutes

Medicare CPT 99291 pays $308.96 in a non-facility setting and $199.07 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $281.30 in Arkansas to $386.53 in Alaska, a 37% spread.

Web page: https://www.med-reveal.com/rates/99291-cpt-fee-schedule
Section: Evaluation and Management
Billed by: Emergency Medicine, Evaluation, General Acute Care Hospital, General Surgery, Hematology & Oncology, Neurological Surgery, Thoracic Surgery (Cardiothoracic Vascular Surgery), Vascular Surgery

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $308.96 |
| National facility | $199.07 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $386.53 | $269.49 |
| District of Columbia | $344.32 | $214.87 |
| New York | $338.17 | $215.58 |
| New Jersey | $336.02 | $212.29 |
| California | $333.57 | $203.54 |
| Washington | $330.51 | $205.24 |
| Massachusetts | $328.54 | $205.08 |
| Connecticut | $326.22 | $207.87 |
| Florida | $323.98 | $213.73 |
| Hawaii | $322.12 | $197.18 |
| Illinois | $318.64 | $212.46 |
| Maryland | $318.19 | $203.63 |
| Colorado | $316.57 | $199.65 |
| Rhode Island | $314.88 | $201.37 |
| Oregon | $313.58 | $197.81 |
| New Hampshire | $312.91 | $198.52 |
| Puerto Rico | $310.30 | $199.21 |
| Virgin Islands | $310.30 | $199.21 |
| Montana | $308.93 | $199.04 |
| Pennsylvania | $308.43 | $200.80 |
| Nevada | $306.54 | $196.54 |
| Michigan | $306.48 | $203.30 |
| Texas | $306.47 | $198.29 |
| Delaware | $306.44 | $197.87 |
| Georgia | $305.61 | $200.77 |
| Wyoming | $304.96 | $195.07 |
| Arizona | $302.30 | $195.82 |
| Minnesota | $302.30 | $189.22 |
| Virginia | $302.01 | $193.98 |
| New Mexico | $300.15 | $199.39 |
| Vermont | $299.94 | $191.15 |
| North Dakota | $299.83 | $189.94 |
| Utah | $298.79 | $195.50 |
| South Dakota | $298.76 | $188.87 |
| Louisiana | $297.21 | $196.89 |
| Missouri | $296.92 | $196.08 |
| Maine | $296.85 | $191.85 |
| West Virginia | $296.81 | $201.32 |
| Ohio | $296.62 | $196.29 |
| South Carolina | $295.76 | $194.23 |
| North Carolina | $293.81 | $191.28 |
| Wisconsin | $292.31 | $187.03 |
| Kentucky | $291.75 | $194.06 |
| Indiana | $290.60 | $188.73 |
| Oklahoma | $290.20 | $192.07 |
| Idaho | $289.40 | $188.30 |
| Tennessee | $288.81 | $188.92 |
| Nebraska | $288.37 | $186.94 |
| Kansas | $287.58 | $188.24 |
| Iowa | $287.51 | $186.97 |
| Mississippi | $285.03 | $190.42 |
| Alabama | $284.38 | $188.23 |
| Arkansas | $281.30 | $186.91 |

## Related codes

- 99292: Critical care, each additional 30 minutes (add-on) — https://www.med-reveal.com/rates/99292-cpt-fee-schedule
- 99468: Neonatal critical care, initial inpatient care, per day, for a critically ill neonate (28 days of age or younger) — https://www.med-reveal.com/rates/99468-cpt-fee-schedule
- 99469: Neonatal critical care, subsequent inpatient care, per day, for a critically ill neonate — https://www.med-reveal.com/rates/99469-cpt-fee-schedule
- 99471: Pediatric critical care, initial inpatient care, per day, for a critically ill infant (29 days through 24 months) — https://www.med-reveal.com/rates/99471-cpt-fee-schedule
- 99472: Pediatric critical care, subsequent inpatient care, per day, for a critically ill infant — https://www.med-reveal.com/rates/99472-cpt-fee-schedule
- 99475: Pediatric critical care, initial inpatient care, per day, for a critically ill patient (2 through 5 years) — https://www.med-reveal.com/rates/99475-cpt-fee-schedule
- 99476: Pediatric critical care, subsequent inpatient care, per day, for a critically ill patient — https://www.med-reveal.com/rates/99476-cpt-fee-schedule
- 99477: Initial hospital care, per day, for a neonate requiring intensive observation, not critically ill — https://www.med-reveal.com/rates/99477-cpt-fee-schedule

Commercial negotiated rates for 99291 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