Emergency Room Visit: What Should It Cost?
ER visits are among the most heavily overcharged services in US healthcare. Bills routinely arrive at 5–10x Medicare rates, and errors like upcoding and unbundling are common.
Medicare Rates for Common Emergency Room Visit Codes
These are the 2025 national Medicare reimbursement rates. Hospital charges for uninsured patients are typically 3–10x higher.
| CPT Code | Description | Medicare (Non-Facility) | Medicare (Facility) |
|---|---|---|---|
| 99283 | ER Visit — Moderate Severity | $70.03 | $70.03 |
| 99284 | ER Visit — High Severity | $119.24 | $119.24 |
| 99285 | ER Visit — High Severity, High Threat | $172.76 | $172.76 |
| 93000 | EKG with Interpretation | $14.47 | $14.47 |
| 71046 | Chest X-ray (2 views) | $34.29 | $34.29 |
| 85025 | Complete Blood Count (CBC) | $7.77 | Lab rate† |
| 80053 | Comprehensive Metabolic Panel | $10.56 | Lab rate† |
| 36415 | Blood Draw | $9.09 | Lab rate† |
† Lab codes are paid under the Clinical Laboratory Fee Schedule (CLFS), not the Physician Fee Schedule. The rate shown is the 2025 Medicare CLFS national limit.
Common Billing Errors for Emergency Room Visit
- !Upcoding the E&M level (e.g., billing 99285 when 99283 is correct)
- !Facility fee charged separately from physician fee without disclosure
- !Duplicate charges for labs run more than once
- !IV supplies and medications billed at chargemaster rates (often 50–100x cost)
How to Negotiate Your Emergency Room Visit Bill
- 1Request an itemized bill with CPT codes before paying anything
- 2Look up the E&M code (99281–99285) and verify the complexity level matches your visit
- 3Ask about self-pay or financial hardship discounts — many hospitals offer 20–40% off
- 4Use the Medicare rate for each line item as your negotiating anchor
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Analyze My BillMedicare rates shown are 2025 national averages from the CMS Physician Fee Schedule. Rates vary by geographic locality. This page is for informational purposes only.