ER visit · CPT 99284

What is CPT code 99284?

Emergency department visit, high-moderate level (level 4 of 5).

By Justin Feldstein · Reviewed 2026-06-15

What it covers

This is the second-highest tier on the emergency department's five-level scale, used for a visit that involved moderate-complexity decision-making and a more detailed workup. It often reflects a presentation the ER had to investigate carefully, such as chest pain that needed an EKG and labs to rule things out, a possible fracture, or symptoms that required several tests before you could safely be sent home. The level is driven by the complexity of the medical decisions, not by your time in the waiting room.

When you'd see it

You'll see this after an ER visit where the team ran a real workup, ordered imaging or bloodwork, and spent meaningful effort sorting out what was going on before discharging you.

Roughly what it costs

$600–$2800 commonly billed

A ballpark on the billed amount. After insurance or a negotiated rate, what you owe is often far lower. Always compare against your Explanation of Benefits (EOB).

What's usually billed with it

Expect a hospital facility fee and a separate physician fee for the same visit, plus individual line items for any EKG, CT scan, lab panels, or medications given in the ER.

99284 vs 99283

Level 3 is one step down and reflects lower-complexity decision-making, so if your visit was quick and required little testing, it's fair to ask why it landed at level 4 instead. See 99283 (ER level 3).

What to watch for

The jump from level 4 to level 5 is one of the biggest single-line cost increases on an ER bill, so ask billing to explain what made your visit a level 4 and confirm it wasn't pushed to 99285 without high-complexity decision-making to support it.

Specific things to question

• Up-leveled to 99285 (the top level) when the visit didn't involve the highest-complexity, high-risk decision-making.
• The facility-fee level not matching the physician-fee level for the same visit, with no explanation.
• Tests and supplies double-counted, appearing both as standalone charges and folded into the visit level.

How to check this charge on your own bill

Find 99284 on your itemized bill and match it against your EOB. Confirm it appears only once, that any bundled services aren't also billed separately, and that the amount matches what your insurer says it allowed. If something doesn't line up, that's a fair question for the billing office.