99284 is the CPT code for: Emergency department visit with moderate level of medical decision making. In 2024, 65,448 providers billed 99284 4,389,227 times, with an estimated $374.8M paid by Medicare.
Medicare's 2026 Physician Fee Schedule national rate for 99284 is $118.24 in the facility setting. National amounts before geographic adjustment — your locality's rate differs slightly.
What Medicare actually paid per service in 2024, on average: $85.40 (observed payment across all settings and modifiers — not a fee-schedule rate).
The top 5 billers nationally, ranked by 2024 Medicare service volume.
| # | Provider | Specialty | Location | Services | Est. Medicare paid |
|---|---|---|---|---|---|
| 1 | Randy Grinspan, DO | Emergency Medicine | Norristown, PA | 794 | $76K |
| 2 | Leonard Simmons, P.A. | Physician Assistant | Pensacola, FL | 784 | $55K |
| 3 | Duane Godshall, MD | Emergency Medicine | Paoli, PA | 714 | $68K |
| 4 | Sally Speck, MD | Emergency Medicine | Paoli, PA | 697 | $66K |
| 5 | Mark Reutter, D.O. | Emergency Medicine | Media, PA | 635 | $60K |
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