Outpatient / APC 5115
APC 5115 · 2,213 hospitals · 364,964 services
Level 5 Musculoskeletal Procedures
Hospital outpatient departments billed Medicare for 364,964 services in APC 5115 in 2024. They charged an average of $72,811; Medicare allowed $12,402 — a ratio of 5.9 to 1 — and paid $10,772 of it, the patient's coinsurance making up most of the rest. Average charges ranged from $15,824 to $374,755 across hospitals.
- 1Average charge $72,811
- 2Medicare allowed $12,402
- 3Reporting hospitals 2,213
- 4Services 364,964
By state
The average charge for this service was highest in Alaska ($126,408) and lowest in Rhode Island ($31,558). 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 |
|---|---|---|---|
| Alaska | 992 | $126,408 | $13,858 |
| Nevada | 2,161 | $113,166 | $13,957 |
| California | 27,291 | $109,149 | $16,484 |
| Florida | 23,560 | $106,979 | $11,798 |
| Texas | 27,432 | $98,771 | $11,615 |
| Arizona | 9,091 | $91,091 | $12,802 |
| Colorado | 8,272 | $89,547 | $12,564 |
| Kentucky | 5,137 | $87,601 | $11,261 |
| Virginia | 13,194 | $83,920 | $11,531 |
| Georgia | 9,074 | $81,545 | $11,644 |
| South Carolina | 9,054 | $80,461 | $11,243 |
| Alabama | 5,579 | $79,031 | $10,734 |
| Indiana | 9,680 | $77,048 | $11,756 |
| New Mexico | 2,067 | $73,720 | $11,708 |
| Washington | 7,889 | $69,838 | $13,450 |
| New Hampshire | 2,210 | $68,487 | $12,716 |
| New York | 13,716 | $67,926 | $14,226 |
| Illinois | 15,024 | $67,146 | $12,333 |
| Tennessee | 8,259 | $65,840 | $10,866 |
| New Jersey | 10,193 | $63,772 | $14,068 |
| Pennsylvania | 17,938 | $63,627 | $12,204 |
| Oklahoma | 7,054 | $63,625 | $11,159 |
| Louisiana | 5,499 | $63,573 | $10,911 |
| Mississippi | 2,019 | $63,410 | $10,843 |
| District of Columbia | 778 | $61,377 | $13,275 |
| North Carolina | 11,866 | $61,166 | $11,650 |
| Utah | 3,871 | $60,839 | $11,713 |
| Ohio | 15,273 | $58,420 | $11,124 |
| West Virginia | 2,049 | $56,161 | $11,009 |
| Wyoming | 919 | $54,760 | $12,806 |
| Hawaii | 699 | $54,220 | $14,773 |
| Kansas | 6,101 | $53,168 | $11,340 |
| Maine | 1,598 | $52,811 | $12,044 |
| Missouri | 8,660 | $52,262 | $11,418 |
| Oregon | 3,611 | $52,209 | $13,931 |
| Idaho | 2,954 | $51,453 | $11,894 |
| Wisconsin | 7,740 | $50,282 | $11,921 |
| Connecticut | 3,607 | $49,698 | $14,580 |
| Iowa | 5,838 | $49,177 | $11,405 |
| South Dakota | 3,869 | $48,584 | $12,387 |
| Michigan | 8,603 | $48,446 | $11,532 |
| Nebraska | 4,946 | $46,218 | $11,797 |
| Montana | 2,257 | $42,843 | $12,302 |
| Arkansas | 5,210 | $42,388 | $11,206 |
| Delaware | 2,342 | $42,292 | $13,085 |
| Vermont | 927 | $40,026 | $6,642 |
| Minnesota | 6,543 | $39,247 | $12,735 |
| North Dakota | 1,935 | $38,474 | $12,448 |
| Massachusetts | 9,407 | $35,549 | $13,997 |
| Rhode Island | 830 | $31,558 | $13,278 |
Highest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Woodland Heights Medical Center Lufkin, TX | $374,755 | $11,406 |
| Medical City Denton Denton, TX | $351,894 | $11,866 |
| Medical City Mckinney Mckinney, TX | $295,710 | $11,737 |
| Good Samaritan Hospital San Jose, CA | $293,615 | $18,234 |
| Henrico Doctors' Hospital Richmond, VA | $290,759 | $11,330 |
| Cjw Medical Center Richmond, VA | $290,537 | $11,256 |
| Tricities Hospital Hopewell, VA | $287,754 | $11,133 |
| Medical City Las Colinas Irving, TX | $271,438 | $11,828 |
| HCA Houston Healthcare Northwest Houston, TX | $268,548 | $12,187 |
| CHRISTUS Southern New Mexico Alamogordo, NM | $264,902 | $12,258 |
Lowest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Cambridge Health Alliance Cambridge, MA | $15,824 | $13,750 |
| Bertrand Chaffee Hospital Springville, NY | $16,475 | $13,930 |
| Ascension St Joseph Hospital Tawas City, MI | $16,813 | $12,341 |
| Mount Auburn Hospital Cambridge, MA | $18,235 | $13,915 |
| West Calcasieu Cameron Hospital Sulphur, LA | $19,260 | $11,044 |
| St Bernards Medical Center Jonesboro, AR | $19,488 | $11,021 |
| North Baldwin Infirmary Bay Minette, AL | $19,606 | $10,913 |
| Beverly Hospital Corporation Beverly, MA | $20,211 | $13,913 |
| Och Regional Medical Center Starkville, MS | $20,820 | $10,737 |
| Kansas Medical Center LLC Andover, KS | $21,259 | $11,223 |
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.