For data year 2023, the data element TOTCH_ED_2023 is included in the Nationwide Emergency Department Sample (NEDS). It represents the total hospital charge for treat-and-release ED visits, with an adjustment applied only to visits in the Western region. This adjustment was introduced due to changes in the states available to participate in the 2023 NEDS and the need to produce accurate national estimates. The data element TOTCHG_ED_2023 is not available for ED visits that result in admission to the same hospital. Additional relevant information can be found in the 2023 NEDS Introduction.