What is CPT Code 99285?
CPT 99285 represents Emergency Room Level 5. It is one of the most frequently abused billing codes in hospital medicine. Billed for minor ER visits that qualify as Level 2 or 3.
When This Code Appears on Your Bill
You may have this code on your bill if you received any of the following:
- Minor cuts requiring stitches
- Simple fractures
- UTI treatment
- Mild asthma attack
Check if your ER visit was truly life-threatening. Level 5 (99285) requires high complexity medical decision-making. If you walked in and walked out within 2 hours for a non-emergency, you were likely billed at too high a level.
CPT 99285 Rate Comparison
Rate benchmarks for CPT 99285
You have the right to request an itemized bill and compare every CPT code against published Medicare rates. If you find CPT 99285 billed above the Medicare rate without justification, you can formally dispute the charge. Hospitals must respond within 30 days.
Found CPT 99285 on your bill?
Our auditors check this code — and every other line item — against Medicare rates and billing guidelines. Most bills with CPT 99285 have additional errors too.
Related CPT Codes to Check
If CPT 99285 appears on your bill, also check these commonly paired or confused codes:
How to Dispute a CPT 99285 Overcharge
- Request your itemized bill from the hospital billing department
- Look up CPT 99285 on cms.gov/medicare/physician-fee-schedule
- Calculate the difference between what you were charged and Medicare rate
- Write a formal dispute letter citing CPT 99285 and the specific dollar discrepancy
- Send via certified mail to Patient Financial Services
- Follow up on day 20 if no response — escalate to Patient Advocate if needed