What is the top of the local market (P90) for CPT 99292 under Bcbsok for Des Moines-West Des Moines, IA providers?

The P90, the top of the local market and Reddenda's target rate, is $267.50.

How does Bcbsok's rate for CPT 99292 compare to Medicare?

The Bcbsok local median of $227.30 is 170% of Medicare's national non-facility rate of $133.94 for CPT 99292.

Reddenda · Rate Intelligence · Des Moines-West Des Moines, IA

99292 under Bcbsok, for Des Moines-West Des Moines, IA providers

Name: Bcbsok rates for CPT 99292 among Des Moines-West Des Moines, IA providers
Creator: Reddenda

Critical care, each additional 30 min · Local peer median $227.30 · High confidence

$227.30 local peer median. Bcbsok's published rate file lists a local peer median of $227.30 for CPT 99292 (Critical care, each additional 30 min) among 830 indexed providers in Des Moines-West Des Moines, IA. Where a Blue Cross entity’s label carries a state, that state names the file we found the rate in, not the provider’s location. Blue Cross plans file separately per state and do not share rates, even for the same provider. The top of that filed distribution, the P90 target, is $267.50, 18% above the median. A provider billed below this median is being paid less than peers holding the identical Bcbsok contract for the identical code. Modeled from published rates, not guaranteed.

Local distribution · 830 providers · 830 rate records

P10

$214

P25

$227.30

Median

$227.30

P75

$267.50

P90 (target)

$267.50

P10$214

P25$227.30

Median (P50)$227.30

P75$267.50

P90 target$267.50

Peer basis: local peer distribution: same CPT, same payer file, same metro (CBSA) Benchmark: local peer median; never a national average Range: $101.30 – $300.47

The local peer median for CPT 99292 under Bcbsok for Des Moines-West Des Moines, IA providers is $227.30, drawn from 830 distinct providers.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsok to publish this rate
The bottom of the local market (P10) is $214 and the top (P90) is $267.50; the median-to-P90 spread is $40.20.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsok to publish this rate
The lowest published rate in this market is $101.30; the highest is $300.47.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsok to publish this rate
This benchmark is drawn from 830 individual rate records that Bcbsok itself published for this code in this metro.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsok to publish this rate
Medicare's national non-facility rate for CPT 99292 is $133.94, making the Bcbsok local median 170% of Medicare.Source: Medicare Physician Fee Schedule; the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsok to publish this rate
45.9% of indexed providers cluster at the single most common rate; the remainder shows a real, scoreable spread across the local market.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsok to publish this rate
A federal No Surprises Act arbitrator may weigh up to four plan years of a provider's own contracted rate history and local market share when resolving a payment dispute over this exact code and payer.Source: 45 CFR §149.510(c)(4)(iii)(B)

830 providers bill this code to this payer in this metro.

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These are the rates Bcbsok publishes for CPT 99292 (Critical care, each additional 30 min) among Des Moines-West Des Moines, IA providers. Enter your NPI to see your own contracted rate against this peer curve, per payer and per code. Free, about 15 seconds, no card and no PHI.

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Documented reimbursement opportunity, modeled from published rates and never a guaranteed outcome.

Modeled from Bcbsok's own published in-network rates, never guaranteed and never a national average. Peer basis: same CPT, same payer file, same metro (CBSA). Federal citation for the underlying obligation: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsok to publish this rate. Page generated 2026-08-23 23:50 UTC; the live index is queried in real time on every request.