Price Checker / CPT 99284
CPT 99284 — Emergency dept visit mod mdm
2026 Medicare Physician Fee Schedule rates and hospital pricing data
$118
What Medicare pays in a hospital/ASC setting
$118
What Medicare pays in a physician's office
$4,832
Based on 98 hospital(s) in our database
What do these numbers mean?
The Medicare rateis what the federal government determines is a fair payment for this procedure. It's based on the Relative Value Unit (RVU) system, which accounts for physician work, practice expense, and malpractice cost. Hospitals and providers often charge 3-20x this amount. If your bill is significantly higher than the Medicare rate, you may have grounds to negotiate.
Hospital Charges for CPT 99284
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| St. Elizabeth Community Hospital , CA | $25,397 | $14,832 | 21379% |
| Mercy Medical Center - Redding , CA | $22,368 | $11,341 | 18817% |
| Mercy Hospital of Folsom , CA | $20,093 | $7,816 | 16893% |
| Methodist Hospital of Sacramento , CA | $20,093 | $5,787 | 16893% |
| Woodland Memorial Hospital , CA | $20,093 | $5,505 | 16893% |
| Astera Health , MN | $15,535 | $11,216 | 13038% |
| Emanuel Medical Center , CA | $12,123 | $9,092 | 10153% |
| Sharp Chula Vista Medical Center , CA | $10,400 | $7,800 | 8696% |
| Sharp Coronado Hospital , CA | $10,400 | $7,800 | 8696% |
| Sharp Grossmont Hospital , CA | $10,400 | $7,800 | 8696% |
| Sharp Mary Birch Hospital for Women and Newborns , CA | $10,400 | $7,800 | 8696% |
| Sharp McDonald Center , CA | $10,400 | $7,800 | 8696% |
| Sharp Memorial Hospital , CA | $10,400 | $7,800 | 8696% |
| Longmont United Hospital , CO | $7,868 | $3,147 | 6554% |
| OrthoColorado Hospital at St. Anthony Campus , CO | $7,868 | $3,147 | 6554% |
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About CPT 99284
CPT code 99284 refers to “Emergency dept visit mod mdm”. Under the 2026 Medicare Physician Fee Schedule, this procedure is reimbursed at $118 in a facility (hospital or ambulatory surgery center) and $118in a non-facility (physician's office) setting.
These rates are set by CMS (Centers for Medicare & Medicaid Services) and represent what the government considers a fair payment for this service. While commercial insurance typically pays somewhat more than Medicare, many hospitals charge significantly higher amounts — sometimes 10-50x the Medicare rate.
What to do if you were overcharged
- Upload your bill— we'll identify this code and compare it against the rates shown above.
- Get a dispute letter— citing the Medicare rate and your hospital's own published pricing data.
- Negotiate or let us handle it — 25% of savings, no savings = no fee.