Top billers · Codes · 99284

Who bills 99284?

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.

$118.24
2026 PFS national rate (facility)
65,448
Providers billing it (2024)
4,389,227
Services billed
$374.8M
Est. Medicare paid
The fee

What does Medicare pay for 99284?

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.

Office (non-facility) rateNo separate office rate
Facility rate$118.24
Fee schedule2026 Medicare Physician Fee Schedule

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 list

Who bills 99284 the most.

The top 5 billers nationally, ranked by 2024 Medicare service volume.

#ProviderSpecialtyLocationServicesEst. Medicare paid
1Randy Grinspan, DOEmergency MedicineNorristown, PA794$76K
2Leonard Simmons, P.A.Physician AssistantPensacola, FL784$55K
3Duane Godshall, MDEmergency MedicinePaoli, PA714$68K
4Sally Speck, MDEmergency MedicinePaoli, PA697$66K
5Mark Reutter, D.O.Emergency MedicineMedia, PA635$60K

65,443 more providers billed 99284 in 2024. The full ranked list — filtered to your exact territory, with phone numbers and year-over-year history — is one search in Prospect 811.

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The breakdown

Where 99284 gets billed.

Top states by volume

California362,204 services
Florida284,773 services
Texas276,798 services
New York275,596 services
Pennsylvania245,103 services
Illinois201,214 services
Ohio180,905 services
Michigan175,476 services

About this code

CMS descriptionEmergency department visit with moderate level of medical decision making
Code typeCPT (Level I HCPCS)
Providers billing it (2024)65,448
Services billed (2024)4,389,227
Avg. Medicare payment per service (2024)$85.40
Where these numbers come from. Rates are CMS's own public fee-schedule files — the Physician Fee Schedule, Clinical Laboratory Fee Schedule, ASP drug pricing, DMEPOS, and the OPPS/ASC addenda — each labeled with its file year on this page; national amounts are shown before geographic adjustment. Codes with no separate rate render the fee schedule's own status in words, never a fake $0. Utilization comes from CMS's public Medicare Provider Utilization & Payment data for 2024, the most recent year released. It covers traditional Medicare fee-for-service only (no commercial insurance, no Medicare Advantage), and CMS suppresses any provider-and-code line with fewer than 11 beneficiaries before publishing, so low-volume billers don't appear at all. "Est. Medicare paid" is each billing line's average Medicare payment times its service count, summed — actual per-claim payment varies by setting and modifiers. For drug and supply codes, a "service" is a billed unit (a milligram, a milliliter, a square centimeter), not a patient visit. Code descriptions are CMS's own, from the utilization files. Prospect 811 organizes public data; it doesn't add to or alter it. Not affiliated with or endorsed by CMS. Full detail on the data page.

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