Price Checker / CPT 99461
How much does Init Nb Em Per Day Non-fac cost?
CPT 99461 · Based on 2026 Medicare rates and hospital-published pricing
A fair cash price for this is roughly $140–$280.
Fair price
$140–$280
What this should cost
With insurance
~$220
Typical out-of-pocket
Overcharged if over
$350
Push back above this
Were you billed for this procedure?
Send us your bill and we'll compare every line item against Medicare rates and your hospital's published prices. Free review, no obligation.
About Init Nb Em Per Day Non-fac
CPT code 99461 refers to init nb em per day non-fac (billing description: "Init nb em per day non-fac"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $53 in a facility (hospital or surgery center) and $94 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
- 1Send us your bill — we'll identify this code and compare it against the rates shown above.
- 2Get a dispute letter — citing the Medicare rate and your hospital's own published pricing data.
- 3We negotiate for you — 25% of savings, no savings = no fee.