Outpatient / APC 5112
APC 5112 · 1,819 hospitals · 79,865 services
Level 2 Musculoskeletal Procedures
Hospital outpatient departments billed Medicare for 79,865 services in APC 5112 in 2024. They charged an average of $12,554; Medicare allowed $1,510 — a ratio of 8.3 to 1 — and paid $1,196 of it, the patient's coinsurance making up most of the rest. Average charges ranged from $2,229 to $65,233 across hospitals.
- 1Average charge $12,554
- 2Medicare allowed $1,510
- 3Reporting hospitals 1,819
- 4Services 79,865
By state
The average charge for this service was highest in Nevada ($21,302) and lowest in Vermont ($5,471). 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 | 446 | $21,302 | $1,712 |
| Florida | 3,849 | $20,835 | $1,426 |
| Alabama | 1,026 | $19,793 | $1,305 |
| California | 5,635 | $18,805 | $2,034 |
| Texas | 6,385 | $16,774 | $1,416 |
| Colorado | 904 | $16,060 | $1,515 |
| Georgia | 1,705 | $15,520 | $1,349 |
| Indiana | 1,677 | $14,035 | $1,416 |
| New Jersey | 1,645 | $14,024 | $1,691 |
| Arizona | 1,528 | $13,685 | $1,570 |
| South Carolina | 1,932 | $13,422 | $1,305 |
| New York | 4,956 | $13,038 | $1,731 |
| Louisiana | 1,221 | $12,568 | $1,334 |
| Pennsylvania | 4,564 | $12,460 | $1,453 |
| Illinois | 2,395 | $12,402 | $1,486 |
| Alaska | 195 | $12,229 | $1,697 |
| District of Columbia | 173 | $12,135 | $1,623 |
| Virginia | 2,460 | $12,119 | $1,427 |
| Tennessee | 1,469 | $11,821 | $1,319 |
| Mississippi | 577 | $11,790 | $1,185 |
| Oklahoma | 2,016 | $11,385 | $1,367 |
| New Mexico | 553 | $10,896 | $1,490 |
| Kentucky | 1,152 | $10,868 | $1,362 |
| Missouri | 1,719 | $10,656 | $1,398 |
| Washington | 2,135 | $10,590 | $1,645 |
| Connecticut | 626 | $10,425 | $1,786 |
| Kansas | 1,295 | $10,367 | $1,390 |
| New Hampshire | 495 | $10,349 | $1,522 |
| North Carolina | 2,235 | $10,089 | $1,428 |
| Wisconsin | 1,949 | $10,024 | $1,461 |
| Ohio | 3,798 | $9,815 | $1,347 |
| Iowa | 771 | $9,570 | $1,393 |
| Michigan | 2,205 | $9,325 | $1,381 |
| Wyoming | 145 | $9,313 | $1,590 |
| Hawaii | 287 | $9,172 | $1,890 |
| Oregon | 815 | $8,897 | $1,716 |
| West Virginia | 611 | $8,639 | $1,335 |
| Nebraska | 826 | $8,447 | $1,427 |
| Arkansas | 1,403 | $8,057 | $1,377 |
| Utah | 770 | $7,876 | $1,433 |
| South Dakota | 1,030 | $7,554 | $1,525 |
| North Dakota | 598 | $7,394 | $1,541 |
| Rhode Island | 243 | $7,386 | $1,617 |
| Idaho | 678 | $7,265 | $1,418 |
| Minnesota | 1,431 | $7,038 | $1,528 |
| Massachusetts | 3,729 | $6,876 | $1,709 |
| Maine | 356 | $6,746 | $1,444 |
| Delaware | 338 | $6,372 | $1,610 |
| Montana | 399 | $5,651 | $1,518 |
| Vermont | 501 | $5,471 | $686 |
Highest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| HCA Florida Jfk Hospital Atlantis, FL | $65,233 | $1,456 |
| HCA Florida Highlands Hospital Sebring, FL | $60,242 | $1,456 |
| HCA Florida Pasadena Hospital Saint Petersburg, FL | $59,937 | $1,456 |
| HCA Florida Lake Monroe Hospital Sanford, FL | $57,190 | $1,456 |
| Grandview Medical Center Birmingham, AL | $56,835 | $1,308 |
| Desert Regional Medical Center Palm Springs, CA | $53,877 | $1,976 |
| Gadsden Regional Medical Center Gadsden, AL | $53,259 | $1,333 |
| HCA Florida West Hospital Pensacola, FL | $52,431 | $1,456 |
| HCA Florida Lawnwood Hospital Fort Pierce, FL | $51,337 | $1,456 |
| Doctors Hospital Augusta, GA | $50,410 | $1,360 |
Lowest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Nicholas H Noyes Memorial Hospital Dansville, NY | $2,229 | $1,704 |
| Billings Clinic Hospital Billings, MT | $2,463 | $1,499 |
| Nmc Health Newton, KS | $2,722 | $1,372 |
| Camc Charleston Surgical Hospital Charleston, WV | $2,723 | $1,363 |
| Cumberland Medical Center Crossville, TN | $2,764 | $1,391 |
| The University of Vermont Health Network - Champl Plattsburgh, NY | $2,771 | $1,825 |
| North Carolina Specialty Hospital Durham, NC | $2,835 | $1,450 |
| Umass Memorial Health-Milford Regional Medical Ctr Milford, MA | $2,917 | $1,726 |
| Salina Surgical Hospital Salina, KS | $2,930 | $1,372 |
| Olean General Hospital Olean, NY | $3,016 | $1,825 |
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.