Code Reality Check
99284 reimbursement rate: Emergency dept visit, level 4
Emergency dept visit, level 4 (CPT 99284) pays a median $253.43 in Indiana and $102.66 in Kentucky, against a Medicare anchor of $204.04. 51 of 51 states clear the publication floor.
spread 2.5x top to bottom
Medicare anchor $204.04
51/51 states published
The 50-state spread
as of 2026-07-15| State | Median | vs Medicare | Band | Rate points | Tier |
|---|---|---|---|---|---|
| Indiana | $253.43 | 1.24x | $230–$316 · P90 $316 | 35,702 | Benchmark |
| Wisconsin | $227.55 | 1.12x | $114–$364 · P90 $492 | 30,375 | Benchmark |
| Colorado | $192.84 | 0.95x | $145–$361 · P90 $361 | 7,937 | Benchmark |
| Michigan | $185.00 | 0.91x | $132–$316 · P90 $417 | 4,050 | Benchmark |
| Minnesota | $178.82 | 0.88x | $122–$268 · P90 $332 | 5,149 | Benchmark |
| Idaho | $168.80 | 0.83x | $137–$250 · P90 $369 | 437 | Benchmark |
| Massachusetts | $167.76 | 0.82x | $127–$198 · P90 $325 | 5,453 | Benchmark |
| New Hampshire | $167.76 | 0.82x | $168–$185 · P90 $243 | 6,615 | Benchmark |
| Vermont | $167.76 | 0.82x | $138–$235 · P90 $235 | 885 | Benchmark |
| Utah | $167.64 | 0.82x | $137–$290 · P90 $466 | 715 | Benchmark |
| Nebraska | $163.67 | 0.80x | $126–$243 · P90 $324 | 430 | Benchmark |
| Wyoming | $157.23 | 0.77x | $124–$181 · P90 $223 | 531 | Benchmark |
| Montana | $157.23 | 0.77x | $122–$218 · P90 $355 | 339 | Benchmark |
| District of Columbia | $156.71 | 0.77x | $133–$202 · P90 $268 | 1,082 | Benchmark |
| Oregon | $154.40 | 0.76x | $130–$252 · P90 $395 | 1,286 | Benchmark |
| Maine | $154.07 | 0.76x | $127–$223 · P90 $242 | 9,615 | Benchmark |
| Iowa | $152.86 | 0.75x | $128–$239 · P90 $335 | 1,047 | Benchmark |
| Oklahoma | $152.61 | 0.75x | $129–$221 · P90 $316 | 769 | Benchmark |
| Hawaii | $152.18 | 0.75x | $133–$216 · P90 $359 | 604 | Benchmark |
| Illinois | $151.62 | 0.74x | $119–$269 · P90 $367 | 9,903 | Benchmark |
| North Dakota | $151.52 | 0.74x | $122–$227 · P90 $343 | 215 | Benchmark |
| California | $151.28 | 0.74x | $138–$291 · P90 $434 | 107,453 | Benchmark |
| Nevada | $151.06 | 0.74x | $132–$237 · P90 $395 | 1,171 | Benchmark |
| Pennsylvania | $149.63 | 0.73x | $127–$197 · P90 $290 | 10,919 | Benchmark |
| South Dakota | $148.79 | 0.73x | $119–$226 · P90 $324 | 176 | Benchmark |
| Virginia | $146.96 | 0.72x | $133–$198 · P90 $231 | 13,495 | Benchmark |
| Arizona | $145.79 | 0.71x | $122–$238 · P90 $365 | 2,523 | Benchmark |
| Washington | $145.32 | 0.71x | $122–$241 · P90 $416 | 2,451 | Benchmark |
| New Mexico | $143.65 | 0.70x | $122–$223 · P90 $335 | 726 | Benchmark |
| Mississippi | $143.62 | 0.70x | $122–$204 · P90 $328 | 546 | Benchmark |
| Arkansas | $143.62 | 0.70x | $126–$198 · P90 $277 | 825 | Benchmark |
| Delaware | $143.62 | 0.70x | $122–$213 · P90 $294 | 502 | Benchmark |
| Louisiana | $143.62 | 0.70x | $118–$231 · P90 $370 | 963 | Benchmark |
| Maryland | $143.62 | 0.70x | $122–$198 · P90 $305 | 3,104 | Benchmark |
| Alaska | $143.62 | 0.70x | $119–$226 · P90 $356 | 272 | Benchmark |
| North Carolina | $143.62 | 0.70x | $144–$187 · P90 $198 | 95,178 | Benchmark |
| South Carolina | $143.62 | 0.70x | $124–$198 · P90 $229 | 5,782 | Benchmark |
| Texas | $143.62 | 0.70x | $114–$211 · P90 $354 | 10,013 | Benchmark |
| Tennessee | $142.13 | 0.70x | $118–$198 · P90 $289 | 4,777 | Benchmark |
| Ohio | $142.07 | 0.70x | $108–$213 · P90 $264 | 50,232 | Benchmark |
| New Jersey | $141.26 | 0.69x | $118–$213 · P90 $361 | 15,170 | Benchmark |
| Florida | $139.50 | 0.68x | $120–$198 · P90 $306 | 11,981 | Benchmark |
| West Virginia | $138.67 | 0.68x | $103–$196 · P90 $295 | 958 | Benchmark |
| Rhode Island | $135.67 | 0.66x | $115–$136 · P90 $222 | 4,616 | Benchmark |
| Connecticut | $135.47 | 0.66x | $120–$240 · P90 $364 | 3,198 | Benchmark |
| Missouri | $134.24 | 0.66x | $118–$222 · P90 $596 | 44,852 | Benchmark |
| Alabama | $132.01 | 0.65x | $114–$197 · P90 $262 | 1,900 | Benchmark |
| Kansas | $130.78 | 0.64x | $113–$191 · P90 $251 | 1,226 | Benchmark |
| Georgia | $122.27 | 0.60x | $113–$175 · P90 $243 | 71,008 | Benchmark |
| New York | $121.52 | 0.60x | $118–$217 · P90 $348 | 169,061 | Benchmark |
| Kentucky | $102.66 | 0.50x | $87–$162 · P90 $229 | 15,378 | Benchmark |
Payer-blind local peer percentiles per state, full verified distribution. Publication floor: 11 verified rate points and a non-degenerate spread; the P25–P75 band unlocks at 25 points, P90 at 100 (a smaller cell's P90 is one contract, not a statistic).
Documented reimbursement figures are modeled, not guaranteed. Derived from federally mandated Transparency in Coverage data (45 CFR 147.212). No PHI.
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Cite this page
Source: Reddenda Code Reality Check, CPT 99284. Reddenda. https://reddenda.health/code/99284/
Derivation federally mandated TiC MRFs, verified to provider identity773,595 verified rate points across 51 statesas of 2026-07-15 · methodology v1.0