Outpatient / APC 5114
APC 5114 · 2,236 hospitals · 169,122 services
Level 4 Musculoskeletal Procedures
Hospital outpatient departments billed Medicare for 169,122 services in APC 5114 in 2024. They charged an average of $46,841; Medicare allowed $6,708 — a ratio of 7 to 1 — and paid $5,339 of it, the patient's coinsurance making up most of the rest. Average charges ranged from $8,560 to $242,345 across hospitals.
- 1Average charge $46,841
- 2Medicare allowed $6,708
- 3Reporting hospitals 2,236
- 4Services 169,122
By state
The average charge for this service was highest in Florida ($74,087) and lowest in Rhode Island ($16,342). 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 | 10,280 | $74,087 | $6,397 |
| California | 11,946 | $69,476 | $9,040 |
| Nevada | 1,138 | $67,748 | $7,592 |
| Colorado | 3,160 | $59,796 | $6,821 |
| Texas | 15,195 | $58,833 | $6,317 |
| Alaska | 341 | $57,857 | $7,642 |
| Arizona | 3,602 | $57,782 | $7,010 |
| Georgia | 4,449 | $54,962 | $6,230 |
| Alabama | 3,260 | $54,370 | $5,781 |
| Virginia | 4,483 | $53,311 | $6,334 |
| South Carolina | 4,745 | $51,243 | $5,958 |
| New Mexico | 798 | $49,078 | $6,442 |
| Pennsylvania | 7,205 | $47,486 | $6,567 |
| District of Columbia | 330 | $47,228 | $7,214 |
| Indiana | 4,380 | $46,938 | $6,363 |
| Washington | 3,575 | $45,214 | $7,244 |
| Illinois | 5,823 | $45,012 | $6,654 |
| New Jersey | 3,821 | $44,614 | $7,594 |
| Kentucky | 2,683 | $44,565 | $6,102 |
| Louisiana | 3,030 | $42,639 | $5,936 |
| New Hampshire | 899 | $40,936 | $6,863 |
| Oklahoma | 4,272 | $40,840 | $6,080 |
| Ohio | 6,604 | $40,587 | $6,096 |
| New York | 7,121 | $40,421 | $7,716 |
| Tennessee | 3,687 | $40,281 | $5,872 |
| Mississippi | 1,697 | $39,926 | $5,831 |
| North Carolina | 5,675 | $38,985 | $6,352 |
| Connecticut | 1,166 | $37,660 | $7,918 |
| West Virginia | 1,061 | $36,509 | $6,000 |
| Wyoming | 395 | $35,529 | $6,970 |
| Missouri | 4,474 | $34,980 | $6,179 |
| Utah | 1,807 | $33,581 | $6,369 |
| Oregon | 1,740 | $33,567 | $7,599 |
| Iowa | 1,835 | $33,464 | $6,231 |
| Wisconsin | 3,502 | $32,813 | $6,483 |
| Idaho | 1,643 | $32,787 | $6,476 |
| Kansas | 3,231 | $32,564 | $6,177 |
| South Dakota | 1,996 | $32,535 | $6,722 |
| Delaware | 570 | $32,264 | $7,128 |
| Michigan | 3,986 | $32,152 | $6,195 |
| Hawaii | 427 | $31,953 | $8,110 |
| Maine | 917 | $31,031 | $6,469 |
| Nebraska | 1,960 | $29,725 | $6,398 |
| Montana | 953 | $28,834 | $6,759 |
| Minnesota | 2,473 | $27,184 | $6,908 |
| Arkansas | 3,250 | $27,028 | $6,130 |
| Vermont | 406 | $25,332 | $3,797 |
| Massachusetts | 5,787 | $25,145 | $7,605 |
| North Dakota | 913 | $23,712 | $6,773 |
| Rhode Island | 403 | $16,342 | $7,113 |
Highest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| The Woodlands Specialty Hospital Spring, TX | $242,345 | $6,505 |
| South Texas Health System Behavioral Edinburg, TX | $237,371 | $6,208 |
| HCA Houston Healthcare Tomball Tomball, TX | $230,724 | $6,634 |
| Tricities Hospital Hopewell, VA | $212,110 | $6,225 |
| Northbay Medical Center Fairfield, CA | $208,179 | $10,092 |
| Medical City Arlington Arlington, TX | $206,594 | $6,459 |
| UCLA West Valley Medical Center West Hills, CA | $201,725 | $8,793 |
| HCA Florida St Lucie Hospital Port Saint Lucie, FL | $197,714 | $6,128 |
| Good Samaritan Hospital San Jose, CA | $177,405 | $10,066 |
| Medical City Las Colinas Irving, TX | $177,001 | $6,438 |
Lowest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Mount Auburn Hospital Cambridge, MA | $8,560 | $7,621 |
| Cambridge Health Alliance Cambridge, MA | $10,867 | $7,683 |
| Kansas Medical Center LLC Andover, KS | $11,539 | $6,108 |
| North Baldwin Infirmary Bay Minette, AL | $11,701 | $5,938 |
| South Shore Hospital South Weymouth, MA | $11,948 | $7,588 |
| East Alabama Medical Center Opelika, AL | $12,060 | $6,253 |
| Geneva General Hospital Geneva, NY | $12,153 | $7,585 |
| Beth Israel Deaconess Hospital-Milton Inc Milton, MA | $12,278 | $7,486 |
| Kell West Regional Hospital Wichita Falls, TX | $12,463 | $6,115 |
| St Joseph's Medical Center Yonkers, NY | $12,592 | $8,140 |
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.