Outpatient / APC 5200
APC 5200 · 51 hospitals · 2,288 services
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Hospital outpatient departments billed Medicare for 2,288 services in APC 5200 in 2024. They charged an average of $143,929; Medicare allowed $28,212 — a ratio of 5.1 to 1 — and paid $26,578 of it, the patient's coinsurance making up most of the rest. Average charges ranged from $44,424 to $314,819 across hospitals.
- 1Average charge $143,929
- 2Medicare allowed $28,212
- 3Reporting hospitals 51
- 4Services 2,288
By state
The average charge for this service was highest in Nevada ($253,705) and lowest in Idaho ($65,873). 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 | 30 | $253,705 | $31,724 |
| Arizona | 26 | $208,937 | $28,617 |
| Kentucky | 51 | $206,775 | $25,122 |
| New Jersey | 41 | $200,160 | $32,172 |
| Colorado | 21 | $191,459 | $27,629 |
| California | 166 | $187,137 | $38,179 |
| Washington | 46 | $178,127 | $29,741 |
| Texas | 194 | $175,120 | $26,093 |
| Tennessee | 32 | $166,927 | $24,558 |
| Georgia | 58 | $163,239 | $25,882 |
| Missouri | 61 | $162,406 | $25,430 |
| Illinois | 208 | $156,885 | $27,529 |
| South Dakota | 41 | $155,616 | $27,188 |
| Louisiana | 26 | $152,040 | $24,443 |
| Indiana | 62 | $150,790 | $26,313 |
| Pennsylvania | 52 | $139,134 | $27,197 |
| New York | 230 | $136,965 | $32,108 |
| Virginia | 27 | $133,970 | $25,630 |
| South Carolina | 66 | $128,876 | $25,352 |
| Oklahoma | 80 | $127,251 | $25,042 |
| Iowa | 53 | $120,319 | $25,950 |
| North Dakota | 21 | $117,398 | $27,905 |
| Minnesota | 49 | $113,915 | $28,021 |
| Florida | 90 | $112,711 | $25,979 |
| Nebraska | 57 | $111,480 | $26,115 |
| North Carolina | 72 | $110,370 | $26,035 |
| Michigan | 54 | $109,306 | $25,492 |
| Oregon | 16 | $105,778 | $30,949 |
| Ohio | 57 | $104,803 | $25,275 |
| Kansas | 56 | $104,328 | $25,334 |
| Wisconsin | 42 | $103,632 | $26,819 |
| Arkansas | 13 | $91,071 | $24,525 |
| Connecticut | 66 | $83,311 | $32,472 |
| Massachusetts | 49 | $79,137 | $31,120 |
| Idaho | 14 | $65,873 | $27,969 |
Highest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| NYU Langone Hospitals New York, NY | $314,819 | $32,626 |
| Renown Regional Medical Center Reno, NV | $274,679 | $31,034 |
| Lutheran Hospital of Indiana Fort Wayne, IN | $241,323 | $26,231 |
| Norton Hospital / Norton Healthcare Pavilion / Nor Louisville, KY | $241,000 | $24,921 |
| John Muir Medical Center - Concord Campus Concord, CA | $225,886 | $40,336 |
| Providence Santa Rosa Memorial Hospital Santa Rosa, CA | $222,259 | $40,572 |
| St Lukes Hospital of Kansas City Kansas City, MO | $206,055 | $25,312 |
| John Muir Medical Center - Walnut Creek Campus Walnut Creek, CA | $202,769 | $40,336 |
| Houston Methodist Hospital Houston, TX | $201,324 | $26,873 |
| Avera Heart Hospital of South Dakota Sioux Falls, SD | $196,751 | $27,171 |
Lowest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Cleveland Clinic Hospital Weston, FL | $44,424 | $24,201 |
| Saint Alphonsus Regional Medical Center Boise, ID | $45,585 | $28,051 |
| Hartford Hospital Hartford, CT | $51,987 | $32,323 |
| Strong Memorial Hospital Rochester, NY | $67,268 | $30,723 |
| University of Iowa Health Care Medical Center Iowa City, IA | $69,904 | $25,867 |
| Mercyone North Iowa Medical Center Mason City, IA | $71,656 | $28,090 |
| Stormont Vail Hospital Topeka, KS | $74,325 | $25,312 |
| Alexian Brothers Medical Center 1 Elk Grove Village, IL | $78,960 | $28,186 |
| New York-Presbyterian Hospital New York, NY | $81,135 | $32,971 |
| Mount Sinai Hospital New York, NY | $81,741 | $32,971 |
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.