How much do emergency room procedures cost?

Medicare benchmark rates for common emergency room procedures range from $22.09 to $348.14. Commercial insurers typically pay 1.2–2× these rates. Your actual cost depends on your plan, deductible, and whether the provider is in network.

How do I know if my emergency room bill is too high?

Compare the amount you were charged to the Medicare benchmark for that specific CPT code. If your bill is more than about 2–3× the Medicare rate, it may be worth requesting an itemized bill and negotiating or appealing.

Emergency Room Costs

Medicare benchmark rates for 5 common emergency room procedures, ranging from $22.09 to $348.14. Use these as a reference to check whether your bill is fair.

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Emergency Room Visit, MinorCPT 99281$22.09Medicare rate Emergency Room Visit, Low ComplexityCPT 99282$58.91Medicare rate Emergency Room Visit, Moderate ComplexityCPT 99283$124.75Medicare rate Emergency Room Visit, Moderately High ComplexityCPT 99284$221.48Medicare rate Emergency Room Visit, High ComplexityCPT 99285$348.14Medicare rate

Understanding emergency room costs

An ER visit almost never produces a single charge. You typically receive a facility fee (the hospital's charge for using the ER, billed at one of five severity levels) plus separate professional fees from the ER physician, and often radiologists, pathologists, or specialists who were consulted. Each of these is a distinct claim, which is why ER bills are unusually prone to errors and surprise out-of-network charges.

For emergency room services, commercial insurers typically pay between $26.51 and $696.28 across this category — roughly 1.2 to 2 times Medicare. If you were billed significantly more than the commercial range for your specific procedure, the excess may be negotiable.

Click any procedure above to see its detailed Medicare rate, the typical commercial range, and specific steps for disputing an overcharge.

Common billing problems with emergency room charges

Facility level coded too high

The ER facility fee (99281–99285) is supposed to reflect the resources actually used. A minor visit billed at a level 4 or 5 facility charge is common. The professional fee and facility fee should tell a consistent story about how sick you were.

Out-of-network physicians at an in-network hospital

You can go to an in-network ER and still be treated by out-of-network physician groups. Under the federal No Surprises Act, emergency care generally cannot be balance-billed at out-of-network rates — this is one of the strongest appeal angles for an ER bill.

Duplicate or unbundled ancillary charges

Imaging and labs ordered in the ER are billed separately. Watch for the same test appearing twice, or a panel broken into individual components that add up to more than the panel itself.

How to push back on a emergency room charge

If any portion was processed out-of-network, cite the No Surprises Act before paying. For the facility fee, request the itemized bill and compare the billed level against the actual services rendered.

Rates shown are 2024 CMS Medicare national average payment rates and are provided for informational purposes only. Actual payments vary by geographic area, facility type, and payer contract. This is not medical or financial advice.