CPT 99284 Emergency Medicine
Emergency department visit - moderate-high complexity Cost
Body System: General
Medicare Facility Rate
$141
CMS PFS CY2026
Medicare Non-Facility Rate
$220
Office/clinic setting
Hospital Outpatient
$426
OPPS rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
2.74
Work RVU
1.25
Facility PE RVU
0.38
Malpractice RVU
Cost by Location
| Location | Medicare Rate | Est. Commercial |
|---|---|---|
| AK — ALASKA* | $189 | $283 — $472 |
| AL — ALABAMA | $135 | $203 — $338 |
| AR — ARKANSAS | $134 | $201 — $335 |
| AZ — ARIZONA | $143 | $214 — $357 |
| AZ — Phoenix | $145 | $217 — $362 |
| CA — BAKERSFIELD | $147 | $220 — $367 |
| CA — CHICO | $146 | $218 — $364 |
| CA — EL CENTRO | $146 | $219 — $364 |
| CA — FRESNO | $146 | $218 — $364 |
| CA — HANFORD-CORCORAN | $146 | $218 — $364 |
| CA — LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) | $153 | $230 — $383 |
| CA — Los Angeles | $156 | $233 — $389 |
| CA — MADERA | $146 | $218 — $364 |
| CA — MERCED | $146 | $218 — $364 |
| CA — MODESTO | $146 | $218 — $364 |
| CA — NAPA | $159 | $238 — $397 |
| CA — OXNARD-THOUSAND OAKS-VENTURA | $151 | $227 — $378 |
| CA — REDDING | $146 | $218 — $364 |
| CA — REST OF CALIFORNIA | $146 | $218 — $364 |
| CA — RIVERSIDE-SAN BERNARDINO-ONTARIO | $150 | $225 — $374 |
Frequently Asked Questions
How much does Emergency department visit - moderate-high complexity cost?
The Medicare facility rate is $141. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $426.
How much does Emergency department visit - moderate-high 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 $141.