Outpatient / APC 5113
APC 5113 · 2,123 hospitals · 107,315 services
Level 3 Musculoskeletal Procedures
Hospital outpatient departments billed Medicare for 107,315 services in APC 5113 in 2024. They charged an average of $24,140; Medicare allowed $2,996 — a ratio of 8.1 to 1 — and paid $2,374 of it, the patient's coinsurance making up most of the rest. Average charges ranged from $4,473 to $170,733 across hospitals.
- 1Average charge $24,140
- 2Medicare allowed $2,996
- 3Reporting hospitals 2,123
- 4Services 107,315
By state
The average charge for this service was highest in Florida ($43,452) and lowest in Rhode Island ($8,488). 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 |
|---|---|---|---|
| Florida | 5,301 | $43,452 | $2,882 |
| Nevada | 664 | $42,599 | $3,393 |
| California | 7,114 | $36,238 | $4,058 |
| Alabama | 1,961 | $31,652 | $2,552 |
| Texas | 9,407 | $30,502 | $2,830 |
| Arizona | 2,173 | $29,563 | $3,135 |
| Colorado | 1,572 | $29,507 | $3,070 |
| District of Columbia | 170 | $29,017 | $3,239 |
| Georgia | 2,607 | $28,907 | $2,728 |
| New Mexico | 587 | $28,573 | $2,896 |
| Virginia | 2,675 | $28,468 | $2,857 |
| South Carolina | 2,858 | $26,235 | $2,689 |
| Pennsylvania | 5,217 | $24,818 | $2,901 |
| Indiana | 2,850 | $24,205 | $2,859 |
| New Jersey | 2,194 | $23,956 | $3,400 |
| Illinois | 3,646 | $23,572 | $2,968 |
| Louisiana | 2,024 | $23,541 | $2,669 |
| Washington | 2,008 | $22,436 | $3,261 |
| Tennessee | 2,224 | $22,180 | $2,623 |
| Mississippi | 994 | $21,549 | $2,523 |
| Oklahoma | 3,279 | $21,473 | $2,735 |
| Alaska | 236 | $21,379 | $3,415 |
| Kentucky | 1,805 | $21,278 | $2,725 |
| New York | 5,107 | $20,797 | $3,441 |
| Ohio | 4,847 | $20,370 | $2,715 |
| North Carolina | 3,071 | $20,138 | $2,843 |
| Wyoming | 243 | $18,765 | $3,183 |
| New Hampshire | 569 | $18,736 | $3,117 |
| Missouri | 2,521 | $18,725 | $2,776 |
| Connecticut | 750 | $18,372 | $3,562 |
| Oregon | 1,006 | $18,071 | $3,424 |
| Wisconsin | 2,665 | $17,806 | $2,919 |
| West Virginia | 814 | $17,802 | $2,683 |
| Michigan | 2,841 | $17,487 | $2,781 |
| Iowa | 1,128 | $17,012 | $2,784 |
| Maine | 608 | $16,197 | $2,897 |
| South Dakota | 1,593 | $16,040 | $3,054 |
| Kansas | 2,040 | $15,738 | $2,755 |
| Delaware | 415 | $15,629 | $3,203 |
| Hawaii | 209 | $15,227 | $3,673 |
| Arkansas | 2,175 | $15,199 | $2,749 |
| Idaho | 944 | $15,009 | $2,879 |
| Utah | 1,057 | $14,739 | $2,883 |
| Nebraska | 1,235 | $14,667 | $2,816 |
| Minnesota | 1,791 | $13,214 | $2,976 |
| Massachusetts | 4,120 | $13,150 | $3,415 |
| Montana | 459 | $13,062 | $3,005 |
| North Dakota | 723 | $12,558 | $3,059 |
| Vermont | 413 | $11,847 | $1,583 |
| Rhode Island | 378 | $8,488 | $3,250 |
Highest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Northbay Medical Center Fairfield, CA | $170,733 | $4,657 |
| HCA Florida Fort Walton-Destin Hospital Fort Walton Beach, FL | $122,328 | $2,839 |
| HCA Florida St Lucie Hospital Port Saint Lucie, FL | $118,953 | $2,809 |
| HCA Houston Healthcare Northwest Houston, TX | $118,152 | $3,001 |
| HCA Florida Orange Park Hospital Orange Park, FL | $117,487 | $2,932 |
| Adventhealth Heart of Florida Davenport, FL | $116,433 | $2,932 |
| HCA Healthone Sky Ridge Lone Tree, CO | $113,320 | $3,026 |
| Good Samaritan Hospital San Jose, CA | $113,179 | $4,558 |
| Good Samaritan Medical Center West Palm Beach, FL | $105,566 | $2,932 |
| HCA Florida Jfk Hospital Atlantis, FL | $104,375 | $2,932 |
Lowest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Wayne General Hospital Waynesboro, MS | $4,473 | $2,831 |
| South Shore Hospital South Weymouth, MA | $4,761 | $3,441 |
| Mount Auburn Hospital Cambridge, MA | $4,947 | $3,452 |
| Ed Fraser Memorial Hospital Macclenny, FL | $5,005 | $1,700 |
| Fort Loudon Medical Center Lenoir City, TN | $5,274 | $2,669 |
| Billings Clinic Hospital Billings, MT | $5,443 | $2,884 |
| Uniontown Hospital Uniontown, PA | $5,674 | $2,891 |
| Mobile Infirmary Medical Center Mobile, AL | $5,790 | $2,550 |
| Baystate Wing Hospital and Medical Centers Palmer, MA | $5,843 | $3,476 |
| Brooks-Tlc Hospital System, Inc Dunkirk, NY | $5,904 | $3,675 |
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.