{
    "code": "99283",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/99283/2021/A",
    "release_specific_url": "https://localishealth.com/cpt/99283/2021/A",
    "description": "A moderate-complexity emergency department visit — for example, a laceration needing layered repair, a moderate asthma flare, or abdominal pain that needs basic labs or imaging to rule out something serious. Unlike office visits, ED visit levels are not timed and are not split into new versus established patients; the level depends on the complexity of the medical decision-making documented — the number of problems addressed, the data reviewed, and the risk of the work-up or treatment.",
    "answer": {
        "question": "How much did Medicare pay for CPT 99283 in Q1 2021?",
        "text": "Medicare paid $72.93 for CPT 99283 in the office (non-facility) setting and $72.93 in a facility under the Q1 2021 Physician Fee Schedule, effective January 2021. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This is a 9.8% increase from the previous quarter."
    },
    "release": {
        "schedule": "pfs",
        "year": 2021,
        "quarter": "A",
        "label": "Q1 2021",
        "effective": "January 1 – March 31, 2021",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 72.93,
        "facility": 72.93,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 1.6,
        "practice_expense_non_facility": 0.33,
        "practice_expense_facility": 0.33,
        "malpractice": 0.16
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 34.8931,
    "source": {
        "label": "Physician relative value file (Q1 2021)",
        "cms_url": "https://www.cms.gov/files/zip/rvu21a-updated-01052021.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2021/A",
        "file": "PPRRVU21_JAN.csv",
        "row": 17184,
        "sha256": "8e6212d64ca58c6a20c44ea319d2148c49156b1fe63a6b68e64a5b0695b0e674"
    },
    "modified_at": "2026-08-04T03:10:16+00:00"
}