CPT 99282 Emergency Medicine
Emergency department visit - low complexity Cost
Body System: General
Medicare Facility Rate
$53
CMS PFS CY2026
Medicare Non-Facility Rate
$94
Office/clinic setting
Hospital Outpatient
$157
OPPS rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
0.93
Work RVU
0.58
Facility PE RVU
0.12
Malpractice RVU
Cost by Location
| Location | Medicare Rate | Est. Commercial |
|---|---|---|
| US — Carrier 01112 Locality 05 | $44 | $66 — $110 |
| US — Carrier 01112 Locality 09 | $44 | $67 — $111 |
| US — Carrier 01112 Locality 51 | $43 | $64 — $106 |
| US — Carrier 01112 Locality 52 | $44 | $66 — $110 |
| US — Carrier 01112 Locality 53 | $42 | $64 — $106 |
| US — Carrier 01112 Locality 54 | $40 | $60 — $101 |
| US — Carrier 01112 Locality 55 | $40 | $60 — $100 |
| US — Carrier 01112 Locality 56 | $40 | $60 — $100 |
| US — Carrier 01112 Locality 57 | $40 | $60 — $100 |
| US — Carrier 01112 Locality 58 | $40 | $60 — $100 |
| US — Carrier 01112 Locality 59 | $40 | $60 — $100 |
| US — Carrier 01112 Locality 60 | $40 | $60 — $100 |
| US — Carrier 01112 Locality 61 | $40 | $60 — $100 |
| US — Carrier 01112 Locality 62 | $41 | $62 — $103 |
| US — Carrier 01112 Locality 63 | $41 | $61 — $102 |
| US — Carrier 01112 Locality 64 | $41 | $61 — $102 |
| US — Carrier 01112 Locality 65 | $45 | $67 — $112 |
| US — Carrier 01112 Locality 66 | $41 | $61 — $102 |
| US — Carrier 01112 Locality 67 | $41 | $62 — $103 |
| US — Carrier 01112 Locality 68 | $40 | $60 — $100 |
Frequently Asked Questions
How much does Emergency department visit - low complexity cost?
The Medicare facility rate is $53. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $157.
How much does Emergency department visit - low complexity cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $53.