Medical Expenditure Panel Survey Agency for Healthcare 

Research and Quality

STATISTICAL BRIEF #111 

January 2006 

Highlights 

 In 2003, the average 

expenditure for an 

emergency room visit was 

$560 while the median 

expenditure was $299. 

 Emergency room visits 

involving surgery were 

most expensive on average 

while those where no

special services were 

provided (such as laboratory tests and various

radiological diagnostic 

procedures) tended to be 

least expensive. 

 The average expense for 

an emergency room visit 

was highest for persons 

age 45–64 and lowest for 

children under 18 years of 

age. 

 The average expense for 

an emergency room visit 

was somewhat higher for 

metropolitan statistical 

areas than other less urban

areas. 

 Expenses for emergency 

room visits in 2003 were 

generally higher than for 

other ambulatory visits to 

hospital outpatient department or office-based 

settings.

Expenses for a Hospital Emergency 

Room Visit, 2003 

Steven R. Machlin, MS 

Introduction 

About one of every seven persons in the U.S. civilian noninstitutionalized population was reported to have had an emergency room visit 

in 2003, and emergency department services accounted for 

approximately 10 percent of all ambulatory health care expenditures. 

In general, an emergency room visit is more expensive than 

comparable care received in other ambulatory settings, such as

hospital outpatient departments or physician offices. There is some

concern among policymakers about both the cost and health 

implications of overuse and inappropriate use of emergency rooms, 

particularly for persons with limited access to other ambulatory care. 

This Statistical Brief presents estimates based on data from the 

Household Component of the Medical Expenditure Panel Survey 

(MEPS-HC) on payments for hospital emergency room visits

(excluding those where facility expenses were rolled into a hospital 

admission) among persons in the U.S. civilian noninstitutionalized

population in 2003. Variations in expenses for emergency room visits 

are illustrated according to services that were reported to be provided

as well as selected demographic characteristics of patients. In addition, average expenses are compared to those for visits to other

ambulatory settings. All differences between estimates noted in the 

text are statistically significant at the 0.05 level or better. 

Findings 

Distribution of expenses for emergency room visits 

In 2003, the average total payment from all sources (e.g., private 

insurance, Medicaid, Medicare, out-of-pocket payments, and other 

miscellaneous sources) for an emergency room visit was $560 

(figure 1). However, there was substantial variation across visits in

emergency room expenses. For example, expenses for about 10 

percent of visits were less than $42 (10th percentile) while, at the 

other extreme, expenses for the top 10 percent of visits were greater 

than $1,246 (90th percentile). The highest expenditure visits have a 

disproportionate impact on the average. Consequently, the median 

expense for an emergency room visit of $299 was nearly 50 percent 

lower than the average expense ($560). 
Variation by services received 

Expenses for emergency room care tend to be higher when special services are provided (figure 2). For 

example, in 2003 the average expense for a visit where a surgical procedure was performed (about 7 

percent of all visits) was $904. This average is 42 percent higher than when surgery was not performed 

but at least one other special service (such as laboratory tests, X-rays, and radiological services; see 

Definitions section for complete listing) was provided (about 64 percent of visits). The average for visits 

where no special services were provided (about 29 percent of visits) was only $302, less than half that for 

those with one or more nonsurgical services ($637). 

Variation by selected demographic characteristics 

The average expenditure for an emergency room visit also varies by some demographic characteristics of 

patients. For example, in 2003 the average expense for a visit among persons age 45–64 ($832) was 

substantially higher than for any other age group, lowest for children under 18 ($423), and slightly higher 

for males than females (figure 3). While variation across geographic regions was not significant, the 

average expense for an emergency room visit was higher in metropolitan than nonmetropolitan areas 

(figure 4). 

Comparison to other ambulatory settings 

Expenses for emergency room visits in 2003 were generally higher than for ambulatory visits to hospital 

outpatient department or office-based settings (figure 5). In particular, the median expense for an 

emergency room visit of $299 was more than twice as large as the median expense for a hospital 

outpatient department visit ($131) and nearly five times that for an office-based visit ($63). While average 

expenses for emergency room and hospital outpatient department visits were virtually identical ($560 and 

$557, respectively), both were substantially larger than the average of $121 for office-based visits. 

Data Source 

The estimates in this Statistical Brief are based on data from the MEPS 2003 Emergency Room Visits 

File (HC-077E). Demographic information was linked from the MEPS 2003 Full Year Consolidated Data 

File (HC-079). 

Definitions 

Expenses (also referred to as expenditures or payments) 

Payments from all sources for emergency room visits reported by respondents in the MEPS-HC. Sources 

include direct payments from individuals, private insurance, Medicare, Medicaid, Workers’ Compensation, 

and miscellaneous other sources. Expenditures include those for both facility and separately billed 

physicians’ services. Visits where facility expenses were rolled into a hospital admission are not included. 

Other services 

One or more of the following services reported: laboratory test, sonogram or ultrasound, X-ray, 

mammogram, MRI, CAT scan EKG, ECG, EEG, vaccination, anesthesia, and other miscellaneous 

diagnostic tests. 

Region 

– Northeast: Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, New York, 

New Jersey, and Pennsylvania 

– Midwest: Ohio, Indiana, Illinois, Michigan, Wisconsin, Minnesota, Iowa, Missouri, North Dakota, South 

Dakota, Nebraska, and Kansas 

– South: Delaware, Maryland, District of Columbia, Virginia, West Virginia, North Carolina, South 

Carolina, Georgia, Florida, Kentucky, Tennessee, Alabama, Mississippi, Arkansas, Louisiana, 

Oklahoma, and Texas 

– West: Montana, Idaho, Wyoming, Colorado, New Mexico, Arizona, Utah, Nevada, Washington, Oregon, 

California, Alaska, and Hawaii 
Metropolitan statistical area (MSA) 

Areas designated by the U.S. Office of Management and Budget that are composed of a large population 

nucleus combined with adjacent communities that have a high degree of economic and social integration 

with the nucleus. An MSA has one or more central counties containing the area’s main population 

concentration. 

About MEPS-HC 

MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health 

care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, 

demographic, and economic characteristics for the civilian noninstitutionalized population. It is 

cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health 

Statistics. 

For more information about MEPS, call the MEPS information coordinator at AHRQ (301-427-1656) or 

visit the MEPS Web site at http://www.meps.ahrq.gov/.

References 

For a detailed description of the MEPS survey design, sample design, and methods used to minimize 

sources of nonsampling error, see the following publications: 

Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Design Strategies and Innovations in the Medical Expenditure Panel Survey. Medical Care,

July 2003: 41(7) Supplement: III-5–III-12. 

Suggested Citation 

Machlin, S. R. Expenses for a Hospital Emergency Room Visit, 2003. Statistical Brief #111. January 

2006. Agency for Healthcare Research and Quality, Rockville, Md. 

http://meps.ahrq.gov/mepsweb/data_files/publications/st111/stat111.pdf 

∗ ∗ ∗

AHRQ welcomes questions and comments from readers of this publication who are interested in 

obtaining more information about access, cost, use, financing, and quality of health care in the United 

States. We also invite you to tell us how you are using this Statistical Brief and other MEPS data and 

tools and to share suggestions on how MEPS products might be enhanced to further meet your needs. 

Please e-mail us at mepspd@ahrq.gov or send a letter to the address below: 

Steven B. Cohen, PhD, Director 

Center for Financing, Access, and Cost Trends 

Agency for Healthcare Research and Quality 

540 Gaither Road 

Rockville, MD 20850 
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2003

Figure 1. Distribution of payments for emergency

department visits, 2003

560

42

126

299

627

1,246

0

200

400

600

800

1,000

1,200

1,400

 Average 10th

percentile

25th

percentile

50th

percentile

(Median)

75th

percentile

90th

percentile

D

ollars

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2003

Figure 2. Average payment for an emergency

room visit, by type of service received, 2003

904

637

302

0

200

400

600

800

1,000

Surgery Other services* 

(no surgery)

No special services

D

ollars

*Other services include any of the following: laboratory test, sonogram or ultrasound, X-ray, mammogram, MRI, CAT scan,

EKG, ECG, EEG, vaccination, anesthesia, and other miscellaneous diagnostic tests.
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2003

Figure 3. Average payments for an emergency room 

visit, by age and sex, 2003

423

500

832

561

603

526

0

150

300

450

600

750

900

Under 18 18-44 45-64 65+ Male Female

D

ollars

Age group Sex

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2003

Figure 4. Average payments for an emergency room 

visit, by region and metropolitan status, 2003

519

586

536

614

577

499

0

150

300

450

600

750

900

Northeast Midwest South West MSA non-MSA

D

ollars

Region Metropolitan statistical area
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2003

Figure 5. Average and median payments per

visit, by type of ambulatory setting, 2003

560

299

121

63

557

131

0

100

200

300

400

500

600

Average Median

Emergency room Hospital outpatient department Office-based

D

ollars