CPT 99283 Emergency Medicine
Emergency department visit - moderate complexity Cost
Body System: General
Medicare Facility Rate
$86
CMS PFS CY2026
Medicare Non-Facility Rate
$145
Office/clinic setting
Hospital Outpatient
$279
OPPS rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
1.60
Work RVU
0.85
Facility PE RVU
0.22
Malpractice RVU
Cost by Location
| Location | Medicare Rate | Est. Commercial |
|---|---|---|
| AK — ALASKA* | $114 | $172 — $286 |
| AL — ALABAMA | $82 | $124 — $206 |
| AR — ARKANSAS | $82 | $122 — $204 |
| AZ — ARIZONA | $87 | $131 — $218 |
| AZ — Phoenix | $88 | $133 — $221 |
| CA — BAKERSFIELD | $90 | $135 — $225 |
| CA — CHICO | $89 | $134 — $224 |
| CA — EL CENTRO | $89 | $134 — $224 |
| CA — FRESNO | $89 | $134 — $224 |
| CA — HANFORD-CORCORAN | $89 | $134 — $224 |
| CA — LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) | $94 | $141 — $235 |
| CA — Los Angeles | $96 | $143 — $239 |
| CA — MADERA | $89 | $134 — $224 |
| CA — MERCED | $89 | $134 — $224 |
| CA — MODESTO | $89 | $134 — $224 |
| CA — NAPA | $98 | $147 — $245 |
| CA — OXNARD-THOUSAND OAKS-VENTURA | $93 | $140 — $233 |
| CA — REDDING | $89 | $134 — $224 |
| CA — REST OF CALIFORNIA | $89 | $134 — $224 |
| CA — RIVERSIDE-SAN BERNARDINO-ONTARIO | $92 | $138 — $229 |
Frequently Asked Questions
How much does Emergency department visit - moderate complexity cost?
The Medicare facility rate is $86. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $279.
How much does Emergency department visit - moderate complexity cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $86.