Emergency department visit with straightforward medical decision making
Medicare pricing data for 47,130 providers across 52 states
This procedure has a 6.5x markup — hospitals charge $259.03 but Medicare allows only $39.95. Uninsured patients may face bills 6.5 times higher than what insurance negotiates. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Emergency department visit with straightforward medical decision making (HCPCS code 99282) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $39.95, but hospitals typically charge $259.03 — a 6.5x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $39.95, your out-of-pocket cost would be approximately $7.99. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 6.5x more than what Medicare allows for this procedure. Medicare actually pays $29.37 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $50 | $330 | 156 | 683 | +25.5% |
| New York | $44 | $236 | 3,768 | 15,663 | +9.1% |
| District of Columbia | $43 | $155 | 212 | 968 | +8.9% |
| New Jersey | $42 | $345 | 1,423 | 6,384 | +5.3% |
| Connecticut | $41 | $224 | 799 | 5,536 | +3.6% |
| Puerto Rico | $41 | $128 | 180 | 664 | +3.3% |
| California | $41 | $262 | 3,834 | 11,458 | +3.0% |
| Illinois | $41 | $252 | 1,818 | 7,413 | +2.8% |
| Florida | $41 | $376 | 3,142 | 11,505 | +2.7% |
| Maryland | $41 | $218 | 826 | 2,485 | +2.7% |
| Michigan | $41 | $230 | 1,731 | 5,637 | +1.7% |
| Massachusetts | $40 | $199 | 1,220 | 4,002 | +1.2% |
| Pennsylvania | $40 | $265 | 2,561 | 8,749 | +0.7% |
| Rhode Island | $40 | $270 | 159 | 638 | +0.6% |
| Delaware | $40 | $219 | 161 | 444 | +0.5% |
| Hawaii | $40 | $283 | 95 | 177 | +0.4% |
| Nevada | $40 | $362 | 379 | 1,241 | -0.1% |
| Montana | $40 | $137 | 163 | 1,405 | -0.6% |
| Utah | $40 | $224 | 215 | 715 | -0.9% |
| Ohio | $40 | $296 | 1,628 | 5,200 | -0.9% |
| Washington | $40 | $225 | 638 | 2,324 | -1.1% |
| Wyoming | $39 | $283 | 88 | 487 | -1.2% |
| Louisiana | $39 | $315 | 642 | 2,006 | -1.4% |
| New Mexico | $39 | $205 | 341 | 2,221 | -1.5% |
| West Virginia | $39 | $190 | 491 | 2,504 | -1.5% |
| Texas | $39 | $330 | 3,067 | 9,817 | -1.7% |
| Colorado | $39 | $197 | 752 | 2,510 | -2.1% |
| Maine | $39 | $196 | 362 | 1,930 | -2.6% |
| North Dakota | $39 | $190 | 107 | 359 | -2.6% |
| New Hampshire | $39 | $215 | 241 | 829 | -2.6% |
| Virginia | $39 | $270 | 1,288 | 3,877 | -2.6% |
| Oregon | $39 | $167 | 565 | 2,122 | -2.8% |
| Kentucky | $39 | $298 | 661 | 2,073 | -3.0% |
| Missouri | $39 | $256 | 980 | 4,623 | -3.1% |
| Georgia | $39 | $310 | 1,347 | 3,917 | -3.1% |
| Oklahoma | $39 | $267 | 762 | 4,954 | -3.2% |
| South Carolina | $39 | $260 | 1,108 | 5,422 | -3.4% |
| Arizona | $38 | $244 | 888 | 4,694 | -3.8% |
| Vermont | $38 | $140 | 159 | 937 | -4.2% |
| Minnesota | $38 | $206 | 694 | 2,751 | -4.5% |
| Indiana | $38 | $226 | 1,016 | 3,329 | -4.5% |
| Idaho | $38 | $163 | 170 | 573 | -4.9% |
| Arkansas | $38 | $196 | 446 | 2,798 | -5.1% |
| North Carolina | $38 | $245 | 1,472 | 4,677 | -5.1% |
| South Dakota | $38 | $185 | 134 | 844 | -5.3% |
| Alabama | $38 | $265 | 600 | 2,174 | -5.3% |
| Mississippi | $38 | $190 | 478 | 3,420 | -5.4% |
| Tennessee | $38 | $313 | 1,059 | 4,058 | -5.5% |
| Wisconsin | $38 | $292 | 828 | 3,244 | -5.6% |
| Iowa | $38 | $208 | 457 | 1,819 | -5.9% |
| Kansas | $37 | $183 | 460 | 2,630 | -6.7% |
| Nebraska | $37 | $176 | 274 | 1,534 | -7.7% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber