Emergency department & critical care

99284 - RVUs & Medicare payment (2026)

Emergency department visit, level 4.

Component	Non-facility	Facility
Work RVU	2.74	2.74
Practice expense RVU	0.45	0.45
Malpractice RVU	0.35	0.35
Total RVUs	3.54	3.54
National payment (CF $33.4009)	$118.24	$118.24
Qualifying APM payment (CF $33.5675)	$118.83	$118.83

How 99284 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 99284 ranges from $109.52 in Wisconsin (WI) to $159.73 in Alaska (AK); calculate 99284 for your locality.

Alaska (AK) $159.73 NYC Suburbs/Long Island (NY) $136.96 Miami (FL) $136.73 Chicago (IL) $134.09 Manhattan (NY) $133.38 Queens (NY) $132.00 San Jose-Sunnyvale-Santa Clara (CA) $129.53 East St. Louis (IL) $128.89 National average $118.24 … 97 more localities between … Minnesota (MN) $110.45 Iowa (IA) $109.91 Nebraska (NE) $109.81 Wisconsin (WI) $109.52

Non-facility payment for 99284 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

99281 · emergency department visit, level 1
99282 · emergency department visit, level 2
99283 · emergency department visit, level 3
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 99284 in 2026?

The national non-facility payment is $118.24 and the facility payment is $118.24, 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 99284?

The 2026 work RVU for 99284 is 2.74. Total RVUs are 3.54 in the non-facility setting and 3.54 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.