Cost analysis for CPT 99291 — Critical care delivery critically ill or injured patient, first 30-74 minutes
Average Medicare Payment
$167.39
2023 data
Total Payments (2023)
$902.8M
Services (2023)
5.3M
Price Change (2014–2023)
-4.0%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $174.39 | $882.2M | 5.0M | — |
| 2015 | $175.53 | $894.1M | 5.0M | +0.7% |
| 2016 | $174.50 | $911.8M | 5.2M | -0.6% |
| 2017 | $176.76 | $955.0M | 5.4M | +1.3% |
| 2018 | $174.67 | $961.9M | 5.5M | -1.2% |
| 2019 | $175.18 | $992.9M | 5.6M | +0.3% |
| 2020 | $183.90 | $1.1B | 6.0M | +5.0% |
| 2021 | $183.67 | $1.1B | 5.8M | -0.1% |
| 2022 | $178.86 | $962.8M | 5.4M | -2.6% |
| 2023 | $167.39 | $902.8M | 5.3M | -6.4% |
The most expensive state pays 1.4x more than the cheapest for this procedure. AK averages $218.84 vs NE at $154.51.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $218.84 | $1.5M | 7.0K | 110 |
| NY | $186.22 | $71.0M | 381.0K | 4.7K |
| DC | $180.08 | $6.0M | 33.2K | 405 |
| NJ | $178.87 | $31.6M | 176.6K | 2.0K |
| AP | $178.67 | $69.1K | 387 | 5 |
| XX | $178.07 | $31.7K | 178 | 1 |
| CA | $176.49 | $134.5M | 761.9K | 7.2K |
| MD | $176.24 | $25.2M | 142.7K | 1.6K |
| CT | $174.83 | $12.0M | 68.5K | 1.1K |
| IL | $174.36 | $39.4M | 226.1K | 2.9K |
| MA | $173.65 | $27.6M | 159.0K | 2.1K |
| RI | $172.30 | $3.1M | 17.8K | 297 |
| FL | $171.66 | $74.9M | 436.4K | 4.8K |
| DE | $171.66 | $2.6M | 15.1K | 238 |
| PR | $169.70 | $618.0K | 3.6K | 69 |
| AE | $169.05 | $44.8K | 265 | 7 |
| PA | $168.71 | $44.5M | 264.0K | 3.8K |
| WA | $168.71 | $13.1M | 77.6K | 1.4K |
| MI | $168.62 | $27.3M | 161.9K | 2.7K |
| CO | $167.35 | $12.0M | 72.0K | 1.2K |
| NV | $166.93 | $8.4M | 50.1K | 592 |
| VA | $166.75 | $23.8M | 142.6K | 1.9K |
| HI | $166.34 | $2.9M | 17.2K | 275 |
| ME | $165.98 | $2.2M | 13.5K | 284 |
| GU | $165.73 | $169.9K | 1.0K | 13 |
| LA | $165.19 | $11.0M | 66.4K | 1.0K |
| AZ | $164.58 | $15.7M | 95.2K | 1.2K |
| MT | $164.38 | $1.9M | 11.8K | 200 |
| TX | $164.36 | $64.4M | 392.0K | 4.7K |
| NM | $164.24 | $3.2M | 19.6K | 341 |
| OH | $164.10 | $32.1M | 195.4K | 3.1K |
| OR | $163.84 | $6.3M | 38.5K | 737 |
| WV | $163.84 | $4.1M | 25.1K | 420 |
| VI | $163.75 | $37.7K | 230 | 4 |
| NH | $163.74 | $3.0M | 18.2K | 317 |
| ND | $163.23 | $1.8M | 11.3K | 143 |
| WY | $163.10 | $538.5K | 3.3K | 70 |
| ZZ | $163.06 | $71.4K | 438 | 7 |
| VT | $162.48 | $1.1M | 6.9K | 119 |
| SD | $162.44 | $1.3M | 8.0K | 99 |
| GA | $162.01 | $22.9M | 141.4K | 2.2K |
| MN | $161.72 | $8.6M | 53.0K | 1.1K |
| MO | $161.46 | $16.8M | 103.8K | 1.5K |
| KY | $161.43 | $12.7M | 78.6K | 1.0K |
| UT | $161.01 | $3.5M | 22.0K | 454 |
| NC | $160.12 | $24.5M | 152.8K | 2.6K |
| SC | $159.96 | $11.5M | 72.2K | 1.2K |
| OK | $159.32 | $9.1M | 57.4K | 777 |
| MS | $159.22 | $8.0M | 50.5K | 604 |
| IN | $158.48 | $14.3M | 90.5K | 1.4K |
| WI | $158.16 | $10.0M | 63.4K | 1.2K |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Abdulkareem Sharaf | Cardiology | CA | $725.1K | 4.1K | $176.63 |
| Pankaj Shah | Internal Medicine | TX | $379.0K | 2.3K | $163.03 |
| Alaa Afifi | Cardiac Surgery | CA | $375.1K | 2.1K | $176.60 |
| Zahra Tabassian | Internal Medicine | CA | $369.6K | 2.1K | $176.75 |
| Farid Ghebleh | Pulmonary Disease | AZ | $347.0K | 2.1K | $164.40 |
| Omer Deen | Internal Medicine | CA | $341.9K | 2.0K | $175.05 |
| Vipin Garg | Critical Care (Intensivists) | NJ | $332.8K | 1.8K | $180.57 |
| Muhammad Raza | Critical Care (Intensivists) | AZ | $330.5K | 2.0K | $163.62 |
| Mehmet Demirozu | Internal Medicine | CA | $326.7K | 1.9K | $171.85 |
| George Shahinian | Pulmonary Disease | CA | $303.2K | 1.7K | $176.30 |
| Ashok Mittal | Pulmonary Disease | FL | $295.9K | 1.7K | $173.47 |
| Rosy Joseph | Nephrology | NJ | $286.6K | 1.7K | $172.16 |
| Tuan Nguyen | Cardiology | CA | $278.1K | 1.6K | $176.55 |
| Bijan Moradi | Internal Medicine | FL | $278.0K | 1.6K | $173.76 |
| Richard Tran | Internal Medicine | CA | $273.8K | 1.6K | $174.29 |
| Anthony Saleh | Pulmonary Disease | NY | $263.5K | 1.3K | $195.88 |
| Jeffry Jones | Internal Medicine | CA | $257.4K | 1.5K | $175.45 |
| Rajiv Philip | Pulmonary Disease | CA | $256.8K | 1.5K | $176.61 |
| Reza Tehrani | Internal Medicine | MI | $248.4K | 1.5K | $164.26 |
| Frida Popilevsky | Pulmonary Disease | NY | $247.0K | 1.3K | $195.72 |
Based on the data, CPT 99291 shows a 1.4x variation in pricing across states — relatively consistent by Medicare standards.
Costs have decreased 4% since 2014. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.