ER Visit — High Severity (Level 4)
What should this cost?
Medicare Pays
$295
National benchmark
Typical Range
$1000–$3000
What hospitals charge
Markup
7×
Above Medicare rate
What this code means on your bill
A high-complexity ER visit involving urgent evaluation. Significant medical decision-making is required.
Commonly billed for
Fractures, severe infections, chest pain requiring workup
What to watch for
Upcoding
If your visit seemed straightforward but you see a high-level code, the provider may have billed for a more complex service than what was performed. Compare the code level to the time you actually spent with the doctor.
Duplicate charges
Check if this code appears more than once on the same date of service. Unless you had the same procedure performed twice (rare), a duplicate is likely a billing error.
Price check
If you're being charged more than 3,600 for this service, it's significantly above the typical range. Request an itemized bill and compare against the Medicare rate of $295.
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