Outpatient / APC 5072
APC 5072 · 2,329 hospitals · 326,549 services
Level 2 Excision/ Biopsy/ Incision and Drainage
Hospital outpatient departments billed Medicare for 326,549 services in APC 5072 in 2024. They charged an average of $11,340; Medicare allowed $1,538 — a ratio of 7.4 to 1 — and paid $1,219 of it, the patient's coinsurance making up most of the rest. Average charges ranged from $1,464 to $66,302 across hospitals.
- 1Average charge $11,340
- 2Medicare allowed $1,538
- 3Reporting hospitals 2,329
- 4Services 326,549
By state
The average charge for this service was highest in Nevada ($19,888) and lowest in North Dakota ($6,326). The allowed amount is set by Medicare's outpatient fee schedule, adjusted for local wages, so it varies much less.
| State | Services | Avg charge | Avg allowed |
|---|---|---|---|
| Nevada | 1,310 | $19,888 | $1,726 |
| California | 28,000 | $14,749 | $2,040 |
| Florida | 20,543 | $14,597 | $1,444 |
| Texas | 20,442 | $14,089 | $1,441 |
| Colorado | 4,120 | $13,898 | $1,548 |
| Pennsylvania | 15,674 | $13,651 | $1,478 |
| Georgia | 8,481 | $12,974 | $1,427 |
| New Jersey | 8,508 | $12,828 | $1,726 |
| New York | 20,337 | $12,815 | $1,771 |
| District of Columbia | 1,307 | $11,963 | $1,625 |
| Kentucky | 5,576 | $11,961 | $1,389 |
| Illinois | 15,286 | $11,818 | $1,493 |
| South Carolina | 7,417 | $11,718 | $1,374 |
| Alaska | 733 | $11,706 | $1,706 |
| Arizona | 6,135 | $11,577 | $1,584 |
| Kansas | 3,805 | $11,389 | $1,394 |
| Alabama | 4,922 | $11,270 | $1,321 |
| Virginia | 10,024 | $11,217 | $1,410 |
| Oklahoma | 4,577 | $11,193 | $1,356 |
| Indiana | 8,554 | $10,786 | $1,422 |
| New Mexico | 1,310 | $10,501 | $1,429 |
| Tennessee | 6,254 | $10,318 | $1,324 |
| Connecticut | 3,637 | $10,228 | $1,776 |
| Ohio | 14,116 | $10,162 | $1,349 |
| Louisiana | 4,835 | $9,908 | $1,344 |
| Missouri | 7,603 | $9,865 | $1,394 |
| New Hampshire | 2,357 | $9,741 | $1,430 |
| Washington | 6,341 | $9,672 | $1,656 |
| Mississippi | 3,998 | $9,506 | $1,340 |
| West Virginia | 2,833 | $9,487 | $1,328 |
| North Carolina | 9,262 | $9,423 | $1,418 |
| Utah | 2,456 | $9,394 | $1,452 |
| Wisconsin | 6,999 | $8,908 | $1,480 |
| Nebraska | 2,942 | $8,843 | $1,405 |
| South Dakota | 2,384 | $8,333 | $1,526 |
| Idaho | 2,042 | $8,252 | $1,484 |
| Arkansas | 3,631 | $8,211 | $1,359 |
| Oregon | 3,287 | $8,100 | $1,747 |
| Iowa | 4,181 | $8,055 | $1,414 |
| Hawaii | 993 | $8,002 | $1,806 |
| Delaware | 1,591 | $7,975 | $1,613 |
| Maine | 1,595 | $7,697 | $1,454 |
| Rhode Island | 987 | $7,430 | $1,631 |
| Michigan | 9,539 | $7,344 | $1,425 |
| Minnesota | 7,188 | $7,303 | $1,567 |
| Wyoming | 480 | $7,219 | $1,610 |
| Montana | 1,708 | $6,661 | $1,536 |
| Massachusetts | 13,221 | $6,596 | $1,724 |
| Vermont | 1,080 | $6,527 | $787 |
| North Dakota | 1,934 | $6,326 | $1,539 |
Highest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Medical Center Enterprise Enterprise, AL | $66,302 | $1,249 |
| Adventhealth Port Charlotte Port Charlotte, FL | $51,783 | $1,301 |
| Capital Health Medical Center - Hopewell Pennington, NJ | $49,385 | $1,664 |
| HCA Florida Largo Hospital Largo, FL | $47,513 | $1,469 |
| Regional Medical Center of San Jose San Jose, CA | $47,189 | $2,283 |
| Merit Health Madison Canton, MS | $44,077 | $1,357 |
| South Texas Health System Behavioral Edinburg, TX | $43,210 | $1,407 |
| HCA Florida Jfk Hospital Atlantis, FL | $42,974 | $1,461 |
| HCA Florida Englewood Hospital Englewood, FL | $42,828 | $1,469 |
| HCA Florida Brandon Hospital Brandon, FL | $42,265 | $1,469 |
Lowest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Aurelia Osborn Fox Memorial Hospital Oneonta, NY | $1,464 | $1,841 |
| Wiregrass Medical Center Geneva, AL | $2,009 | $1,328 |
| Bronson South Haven Hospital South Haven, MI | $2,107 | $1,418 |
| Winona Health Services Winona, MN | $2,136 | $1,551 |
| Olmsted Medical Center Rochester, MN | $2,316 | $1,528 |
| Sagewest Health Care Riverton, WY | $2,348 | $1,628 |
| Northern Regional Hospital Mount Airy, NC | $2,571 | $1,333 |
| Presbyterian Santa Fe Medical Center Santa Fe, NM | $2,721 | $796 |
| D W Mcmillan Memorial Hospital Brewton, AL | $2,807 | $1,304 |
| Brooks-Tlc Hospital System, Inc Dunkirk, NY | $2,864 | $1,841 |
An APC groups services of similar cost, so a hospital's average mixes the specific procedures it does most. Charges are list prices; the allowed amount is the fee-schedule total that Medicare and the patient together pay the hospital.
Source: CMS Medicare Outpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024. Checked 2026-10-24. Methodology.