99285 is the CPT code for: Emergency department visit with high level of medical decision making. In 2024, 64,318 providers billed 99285 8,984,062 times, with an estimated $1.2B paid by Medicare.
Medicare's 2026 Physician Fee Schedule national rate for 99285 is $171.35 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: $130.82 (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 | Allen Nau, D.O. | Emergency Medicine | Freehold, NJ | 1,210 | $172K |
| 2 | George Karroum, M.D. | Emergency Medicine | Los Angeles, CA | 1,146 | $150K |
| 3 | Ruslan Ivanov, MD | Family Practice | Hollywood, FL | 1,125 | $151K |
| 4 | James Arnold, M.D. | Emergency Medicine | Hot Springs, AR | 1,108 | $140K |
| 5 | Jay Mccombs, D.O. | Emergency Medicine | Sun City West, AZ | 1,078 | $143K |
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