https://www.npr.org/sections/health-shots/2019/01/28/688350600/a-fainting-spell-after-a-flu-shot-leads-to-4-692-er-visit?utm_source=dlvr.it&utm_medium=twitter&utm_campaign=newsletter_axiosvitals&stream=top

Kaiser Health News and NPR are back with another installment of their “Bill of the Month” series: This time, it’s a guy who fainted after getting a flu shot, was taken to the ER, and ended up with a $4,692 bill.

The biggest culprit, at almost $3,000 of the total bill, was the ER’s “facility fee” — a charge just for walking in the door, not for any particular services.

• Hospitals code each ER visit on a scale of 1 to 6; a 6 is supposed to be reserved for the most critical care, like a gunshot wound. The higher the number, the higher the facility fee.
• The patient in this case was coded as a 5. The hospital, run by Atrium Health, said that’s because he received more than 3 tests.

“It’s not a perfect system. Hospitals have an incentive to do a CT exam, and taxi drivers have an incentive to take the long way home,” the David McKenzie, reimbursement director at the American College of Emergency Physicians, told NPR.

Go deeper: Vox did a good rundown of rising facility fees as part of its own series on hospital billing.