Price Checker / CPT 99291

How much does Critical Care First Hour cost?

CPT 99291 · Based on 2026 Medicare rates and hospital-published pricing

Severe overcharge

The average hospital charge is around 16x the fair price — among the most extreme markups. Dispute this.

Fair price

$460–$930

What this should cost

With insurance

~$87,200

Typical out-of-pocket

Overcharged if over

$1,150

Push back above this

The average hospital charge of $11,246 is $10,546 over the fair price (about 16x the fair rate).

What hospitals charge for Critical Care First Hour

From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.

HospitalGross ChargeCash Ratevs Medicare
Mercy Medical Center - Redding

Redding, CA

$85,59327050%
Palomar Health Medical Center Escondido

Escondido, CA

$58,78618927%
Palomar Medical Center Poway

Poway, CA

$58,78618927%
Intermountain Health Cassia Regional Hospital

Burley, ID

17555%
Gateway Regional Medical Center

Granite City, IL

$12,28511750%
Sharp Memorial Hospital

SAN DIEGO, CA

$29,586$22,1909476%
Carolina Pines Regional Medical Center

Hartsville, SC

$14,5454608%
University of New Mexico Hospital

, NM

$1,2213199%
UNM Sandoval Regional Medical Center

, NM

$1,2213199%
Kohala Hospital

KAPAAU, HI

$6,8092545%
Driscoll Children's Hospital - Rio Grande Valley

Edinburg, TX

$6,1062425%
W.J. Mangold Memorial Hospital

Lockney, TX

$11,8152347%
WellSpan Waynesboro Hospital

Waynesboro, PA

$4,2542341%
Wilcox Medical Center

Lihue, HI

$7,6402002%
23330 Emergency Center, LLC d/b/a/ Elite Hospital Kingwood

Kingwood, TX

$6,0361854%

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About Critical Care First Hour

CPT code 99291 refers to critical care first hour (billing description: "Critical care first hour"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $199 in a facility (hospital or surgery center) and $309 in a doctor's office.

The Medicare rate is the closest thing to an objective "what this work is actually worth." A fair cash price for the uninsured is generally 1.5–3x that rate. Hospital sticker (gross) charges are often far higher — but almost nobody actually pays them.

What to do if you were overcharged

  1. 1Send us your billwe'll identify this code and compare it against the rates shown above.
  2. 2Get a dispute letterciting the Medicare rate and your hospital's own published pricing data.
  3. 3We negotiate for you25% of savings, no savings = no fee.

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