Emergency Room vs Urgent Care: The Price Difference Will Shock You
Comparing ER visit costs vs office visit costs using Medicare data.
When you're sick or injured, do you go to the emergency room or an urgent care clinic? The answer could mean a difference of hundreds — or even thousands — of dollars. We compared ER visit codes (99281-99285) with standard office visit codes (99211-99215) to see just how big the price gap is.
On average, an ER visit costs $81.77 (Medicare-allowed) compared to $87.92 for an office visit — a 0.9300272975432212x difference.
Emergency Room Visit Costs (99281-99285)
ER visits are classified into 5 levels based on severity:
| Code | Level | Medicare Allowed | Hospital Charge | Services |
|---|---|---|---|---|
| 99281 | ER Level 1 — Emergency department visit for problem that may not require health care professional | $11.23 | $132.96 | 9.1K |
| 99282 | ER Level 2 — Emergency department visit with straightforward medical decision making | $39.95 | $259.03 | 182.9K |
| 99283 | ER Level 3 — Emergency department visit with low level of medical decision making | $68.77 | $415.10 | 1.1M |
| 99284 | ER Level 4 — Emergency department visit with moderate level of medical decision making | $116.43 | $781.38 | 4.9M |
| 99285 | ER Level 5 — Emergency department visit with high level of medical decision making | $172.46 | $1,205 | 8.6M |
Office Visit Costs (99211-99215)
Standard office visits also have 5 levels of complexity:
| Code | Level | Medicare Allowed | Hospital Charge | Services |
|---|---|---|---|---|
| 99211 | Level 1 — Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional | $22.38 | $58.77 | 1.6M |
| 99212 | Level 2 — Established patient office or other outpatient visit, 10-19 minutes | $52.30 | $112.61 | 7.4M |
| 99213 | Level 3 — Established patient office or other outpatient visit, 20-29 minutes | $83.97 | $179.13 | 71.5M |
| 99214 | Level 4 — Established patient office or other outpatient visit, 30-39 minutes | $117.90 | $262.19 | 100.6M |
| 99215 | Level 5 — Established patient office or other outpatient visit, 40-54 minutes | $163.05 | $383.55 | 12.1M |
The Bottom Line
For non-emergency situations — a fever, minor injury, or infection — urgent care or a doctor's office visit can save you hundreds of dollars compared to the ER. The ER is essential for true emergencies, but the data shows that millions of lower-acuity ER visits (Levels 1-3) could often be handled at much lower cost in an outpatient setting.
Hospital charges make the gap even worse: ER chargemaster prices are often 5-10x the Medicare rate, while office visit markups are typically 2-3x.