Emergency department & critical care

99281 - RVUs & Medicare payment (2026)

Emergency department visit, level 1.

Component	Non-facility	Facility
Work RVU	0.25	0.25
Practice expense RVU	0.05	0.05
Malpractice RVU	0.03	0.03
Total RVUs	0.33	0.33
National payment (CF $33.4009)	$11.02	$11.02
Qualifying APM payment (CF $33.5675)	$11.08	$11.08

How 99281 payment varies by locality

Medicare adjusts payment with geographic practice cost indices, so the same code pays differently across the 109 fee schedule localities. In 2026, non-facility payment for 99281 ranges from $10.26 in Wisconsin (WI) to $14.86 in Alaska (AK); calculate 99281 for your locality.

Alaska (AK) $14.86 NYC Suburbs/Long Island (NY) $12.73 Miami (FL) $12.62 Manhattan (NY) $12.41 Chicago (IL) $12.39 Queens (NY) $12.30 San Jose-Sunnyvale-Santa Clara (CA) $12.21 San Jose-Sunnyvale-Santa Clara (CA) $12.07 National average $11.02 … 97 more localities between … Arkansas (AR) $10.30 Iowa (IA) $10.28 Nebraska (NE) $10.27 Wisconsin (WI) $10.26

Non-facility payment for 99281 in the 2026 fee schedule ($33.4009 conversion factor), before sequestration. Gray bar = national average.

Global period: XXX

No global period: the global surgery concept does not apply to this code.

Related codes - emergency department & critical care

99282 · emergency department visit, level 2
99283 · emergency department visit, level 3
99284 · emergency department visit, level 4
99285 · emergency department visit, level 5
99291 · critical care, first 30-74 minutes
99292 · critical care, each additional 30 minutes

Frequently asked questions

How much does Medicare pay for 99281 in 2026?

The national non-facility payment is $11.02 and the facility payment is $11.02, using the standard $33.4009 conversion factor. Actual amounts vary by Medicare locality; use the RVU calculator for your area.

What is the work RVU for 99281?

The 2026 work RVU for 99281 is 0.25. Total RVUs are 0.33 in the non-facility setting and 0.33 in the facility setting.

Why are the facility and non-facility amounts different?

Only the practice expense component changes by setting. In an office (non-facility) the practice bears the overhead, so the PE RVU is higher; in a hospital or ASC the facility bills its own overhead separately.

Source: CMS Physician Fee Schedule relative value file (rvu26c.zip, retrieved 2026-07-11). Service description is an original plain-English summary, not CPT descriptor text. CPT® is a registered trademark of the American Medical Association. Amounts are estimates before sequestration and claim-level adjustments.