CPT 99283
ER visit, level 3
The middle emergency room visit level, for low complexity decision making. A sprain that got an x-ray, a cut that got stitches, an infection that got a prescription. This is where a large share of ordinary ER visits belong.
Billed to Medicare
$409
What providers submitted, on average, for this code in a hospital setting.
Medicare accepted
$67
What Medicare treated as payable. Not a commercial rate or a cash price.
The gap
6.1x
How many times the accepted amount the billed figure was.
National averages from the Centers for Medicare & Medicaid Services, 2024 data, retrieved 2026-09-14. Medicare fee-for-service, physician and practitioner claims only. The hospital's own charge for the same code is separate and is usually higher. Based on 980,310 services.
Among the 6 emergency room visit levels codes on this site with CMS figures, this gap ranks 5 of 6 (median 6.4x). The widest is ER visit, level 1 at 15.6x.
Where this line goes wrong
This is the level that gets pushed up
National claims data shows ER visits drifting toward levels 4 and 5 over time, with some of the largest shifts in ordinary diagnoses like rash, cough and nausea. If your problem was a single, uncomplicated one and you were sent home the same day, level 3 is the level to compare your bill against.
Tests ordered count, tests done elsewhere do not
Ordering and reviewing tests raises the decision making score. But the x-ray or blood test itself is billed on its own line. If the level is high because of testing, you should also see those tests itemized; if you do not, ask why the level was justified.
Want to know if this line is right on your own bill? Upload it to a free mediloop account. An automatic first look reads the charges and shows what looks worth questioning, usually in about a minute.
Check my bill for freeCheck it, then ask
- 1
Request the itemized bill and the visit record (the ER note). The level has to be justified by what is written there, not by what happened to you.
- 2
Check which bills carry the code. The hospital and the ER doctor usually each bill a level, and they do not have to match.
- 3
Compare the level to what was done: how many problems were addressed, what tests were ordered and reviewed, and what the decisions were (admit, discharge, prescription, procedure).
- 4
If the visit looks like a lower level, write to the billing office asking for a coding review and say which level you think fits and why. Ask for the response in writing.
The full walkthrough for this kind of bill: You got an ER bill.
Upload the bill to a free mediloop account. An automatic first look reads the charges and shows what looks worth questioning, usually in about a minute. If you want a specialist to dispute it for you, it is a flat $129, refunded in full if the bill isn't lowered by at least $129.
Check my bill for freeNot sure the bill is worth fighting? Run the free savings calculator first
People also ask
Is level 3 the right level for stitches?
Often, yes, when the wound was simple and nothing else was going on. The stitches themselves are billed separately as a wound repair code (12001 and its neighbours), so the level should reflect the decisions around the wound, not the repair.
Can a level 3 visit still be negotiated?
Yes. The level is one line. The facility fee, the supplies and the tests are all separate lines and each can be checked and questioned.
Sources
- ACEP, 2023 AMA CPT documentation guideline changes for ED E/M codes 99281-99285
- Trilliant Health, Changes in coding intensity suggest how upcoding is happening across outpatient settings (May 2025)
This page explains a billing code in general terms. It is not a coding, legal or medical opinion about your bill, and the code descriptions are mediloop's own plain-English summaries, not the official CPT descriptors, which are owned by the American Medical Association. Whether a charge was correct depends on the record of your visit and your payer's rules.