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CPT 99282 · Medicine/E&M · Evaluation & Management

Emergency dept visit sf mdm

Emergency department visits for basic medical decisions range from $40.43 at Medicare rates to $158.36 at hospital outpatient facilities, making it essential to verify your billing codes before paying.

By David Park , Healthcare Cost Researcher · ·
Data from CMS files published FY 2024 CMS IPPS. Refreshed weekly.
About the analyst

David Park researches procedure pricing and insurance reimbursement patterns at BillRazor Research. He specializes in cost comparison across care settings and metropolitan areas. Expertise: procedure pricing, insurance reimbursement, cost comparison.

Medicare + CMS benchmark data
Publicly available pricing
Updated 2026-04-03
Rate comparison — Emergency dept visit sf mdm
Medicare facility$40Non-facility$48Hospital outpatient$158$118 difference between lowest and highest rate
$40
Medicare facility rate
$48
Non-facility rate

CPT code 99282 represents a low-complexity emergency department visit where patients receive basic evaluation and treatment for minor conditions like simple cuts, minor infections, or mild symptoms. This code typically applies to patients with problems that require minimal diagnostic workup and simple medical decision-making. Emergency department visits generally charge significantly higher rates than urgent care centers for the same level of service complexity.

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Compare by care setting
The same procedure costs different amounts depending on where you receive care.
$158
Hospital Outpatient rate for Emergency dept visit sf mdm
Medicare facility benchmark: $40
Regional rate comparison — Emergency dept visit sf mdm
Top 5 lowest and highest localities by Medicare facility rate
National avg $40REST OF ILLINOIS, IL$47DETROIT, MI$49QUEENS, NY$50MIAMI, FL$62CHICAGO, IL$58NYC SUBURBS/LONG ISLAND, NY$55

Facility rate

$40

National Medicare benchmark

Non-facility rate

$48

Office setting benchmark

Data sources

3

23 data points

Key insights for CPT 99282

Facility vs office setting

$8 difference

Facility setting is less expensive for this procedure

What this procedure costs across different settings

The same procedure can cost very different amounts depending on where it's performed. These are the Medicare-allowed amounts — what hospitals actually charge can be 3-10x higher.

SettingMedicare ratevs lowest
Facility (physician office)$40Lowest
Non-facility (office)$48+19%
Outpatient (APC)$158+292%

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About this data

Rates shown are from the 2026 Medicare Physician Fee Schedule, Hospital Outpatient Prospective Payment System (OPPS), Ambulatory Surgery Center Payment System, Clinical Laboratory Fee Schedule, Durable Medical Equipment Fee Schedule, and CMS Inpatient Prospective Payment System (DRG weights). Regional adjustments use CMS Geographic Practice Cost Indices (GPCI). Hospital charges are from CMS Hospital Price Transparency machine-readable files. All data is publicly available under federal law (45 CFR Part 180).

This data is for informational purposes only and does not constitute medical or financial advice. Actual costs depend on insurance coverage, negotiated rates, and individual circumstances.

Related procedures

Rates shown are from the 2026 Medicare Physician Fee Schedule and CMS IPPS. BillRazor compares your bill against these data sources. See how it works →

Related pricing data

Data: Medicare Physician Fee Schedule, CMS Inpatient PPS (IPPS), Outpatient PPS (OPPS), ASC Payment System, Clinical Lab Fee Schedule (CLFS), National Average Drug Acquisition Cost (NADAC). FY 2024 data. All publicly available from CMS.

Methodology: Facility rate applies when the procedure is performed in a hospital or ASC. Non-facility rate applies in a physician office. GPCI adjustments reflect regional cost-of-living differences.

This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use

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