# CPT 99285

> Medicare paid $177.20 for CPT 99285 in the office (non-facility) setting and $177.20 in a facility under the Q3 2020 Physician Fee Schedule, effective July 2020. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2020, when it increased 0.6%.

## 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: Q3 2020 (2020 C)
- Effective: July 1 – September 30, 2020
- Status indicator: A
- Office (non-facility) national allowed amount: $177.20
- Facility national allowed amount: $177.20
- Sequestration: not applied

## RVUs and formula

- Work RVU: 3.80
- Office (non-facility) practice expense RVU: 0.71
- Facility practice expense RVU: 0.71
- Malpractice RVU: 0.40
- Conversion factor: 36.0896
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## Source and citation

- Source: Physician relative value file (Q3 2020)
- CMS file: https://www.cms.gov/files/zip/rvu20c-updated-06192020.zip
- Parsed file: PPRRVU20_V0618.csv, row 17,181
- Canonical page: https://localishealth.com/cpt/99285/2020/A
- Release-specific citation URL: https://localishealth.com/cpt/99285/2020/C
- Last significant update: 2026-08-04T03:09:46+00:00