Price Checker / CPT 99291
CPT 99291 — Critical care first hour
2026 Medicare Physician Fee Schedule rates and hospital pricing data
$199
What Medicare pays in a hospital/ASC setting
$309
What Medicare pays in a physician's office
$17,185
Based on 79 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 99291
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Helen Keller Hospital , AL | $96,425 | $96,425 | 31110% |
| Mercy Medical Center - Redding , CA | $85,593 | $43,396 | 27604% |
| Mercy Medical Center - Redding Redding, CA | $85,593 | — | 27050% |
| Mercy General Hospital , CA | $59,851 | $13,048 | 19272% |
| Mercy Hospital of Folsom , CA | $59,851 | $23,282 | 19272% |
| Mercy San Juan Medical Center , CA | $59,851 | $16,399 | 19272% |
| Methodist Hospital of Sacramento , CA | $59,851 | $17,237 | 19272% |
| Woodland Memorial Hospital , CA | $59,851 | $16,399 | 19272% |
| Palomar Health Medical Center Escondido , CA | $58,786 | $35,272 | 18927% |
| Palomar Health Medical Center Escondido Escondido, CA | $58,786 | — | 18927% |
| Palomar Medical Center Poway , CA | $58,786 | $35,272 | 18927% |
| Palomar Medical Center Poway Poway, CA | $58,786 | — | 18927% |
| Intermountain Health Cassia Regional Hospital Burley, ID | — | — | 17555% |
| Gateway Regional Medical Center Granite City, IL | $12,285 | — | 11750% |
| Sharp Chula Vista Medical Center , CA | $29,586 | $22,190 | 9476% |
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About CPT 99291
CPT code 99291 refers to “Critical care first hour”. Under the 2026 Medicare Physician Fee Schedule, this procedure is reimbursed at $199 in a facility (hospital or ambulatory surgery center) and $309in 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.