Emergency department & critical care

99292 - RVUs & Medicare payment (2026)

Critical care, each additional 30 minutes.

Component	Non-facility	Facility
Work RVU	2.25	2.25
Practice expense RVU	1.53	0.52
Malpractice RVU	0.23	0.23
Total RVUs	4.01	3.00
National payment (CF $33.4009)	$133.94	$100.20
Qualifying APM payment (CF $33.5675)	$134.61	$100.70

How 99292 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 99292 ranges from $123.01 in Arkansas (AR) to $171.39 in Alaska (AK); calculate 99292 for your locality.

Alaska (AK) $171.39 San Jose-Sunnyvale-Santa Clara (CA) $161.23 San Jose-Sunnyvale-Santa Clara (CA) $160.16 San Francisco-Oakland-Berkeley (CA) $157.87 San Francisco-Oakland-Berkeley (CA) $157.61 NYC Suburbs/Long Island (NY) $154.99 Manhattan (NY) $151.53 Queens (NY) $151.44 National average $133.94 … 97 more localities between … Iowa (IA) $124.96 Mississippi (MS) $124.83 Alabama (AL) $124.22 Arkansas (AR) $123.01

Non-facility payment for 99292 in the 2026 fee schedule ($33.4009 conversion factor), before sequestration. Gray bar = national average.

Global period: ZZZ

Add-on code: billed with a primary service and covered by the primary service’s global period.

Related codes - emergency department & critical care

99281 · emergency department visit, level 1
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

Frequently asked questions

How much does Medicare pay for 99292 in 2026?

The national non-facility payment is $133.94 and the facility payment is $100.20, 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 99292?

The 2026 work RVU for 99292 is 2.25. Total RVUs are 4.01 in the non-facility setting and 3.00 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.