# CPT 99285

> Medicare paid $175.44 for CPT 99285 in the office (non-facility) setting and $175.44 in a facility under the Q1 2016 Physician Fee Schedule, effective January 2016. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This is a 1.0% decrease from the previous quarter.

## What it is

The highest-level emergency department visit — for example, signs of stroke, major trauma, or another condition posing an immediate threat to life or a bodily function. It reflects an extensive work-up (multiple studies, often specialist involvement) and treatment decisions carrying significant risk.

## Selected release

- Release: Q1 2016 (2016 A)
- Effective: January 1 – March 31, 2016
- Status indicator: A
- Office (non-facility) national allowed amount: $175.44
- Facility national allowed amount: $175.44
- Sequestration: not applied

## RVUs and formula

- Work RVU: 3.80
- Office (non-facility) practice expense RVU: 0.75
- Facility practice expense RVU: 0.75
- Malpractice RVU: 0.35
- Conversion factor: 35.8043
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## Source and citation

- Source: Physician relative value file (Q1 2016)
- CMS file: https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu16a.zip
- Parsed file: PPRRVU16_V0122.csv, row 16,163
- Canonical page: https://localishealth.com/cpt/99285/2016/A
- Release-specific citation URL: https://localishealth.com/cpt/99285/2016/A
- Last significant update: 2026-08-04T03:06:29+00:00