Outpatient / APC 5222
APC 5222 · 931 hospitals · 36,360 services
Level 2 Pacemaker and Similar Procedures
Hospital outpatient departments billed Medicare for 36,360 services in APC 5222 in 2024. They charged an average of $44,464; Medicare allowed $8,090 — a ratio of 5.5 to 1 — and paid $6,515 of it, the patient's coinsurance making up most of the rest. Average charges ranged from $11,233 to $210,001 across hospitals.
- 1Average charge $44,464
- 2Medicare allowed $8,090
- 3Reporting hospitals 931
- 4Services 36,360
By state
The average charge for this service was highest in Nevada ($78,881) and lowest in Rhode Island ($23,735). 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 | 210 | $78,881 | $9,170 |
| Kentucky | 375 | $63,497 | $7,316 |
| Texas | 2,201 | $62,346 | $7,554 |
| California | 1,907 | $56,165 | $10,891 |
| New York | 3,158 | $54,748 | $9,367 |
| Pennsylvania | 2,066 | $53,932 | $8,052 |
| Alabama | 459 | $53,118 | $7,094 |
| Arizona | 597 | $52,689 | $8,336 |
| Colorado | 507 | $51,445 | $8,126 |
| Florida | 2,588 | $50,055 | $7,621 |
| Utah | 192 | $49,869 | $7,552 |
| District of Columbia | 75 | $48,599 | $8,663 |
| South Carolina | 1,068 | $48,188 | $7,267 |
| New Mexico | 187 | $45,803 | $7,697 |
| Virginia | 897 | $44,669 | $7,630 |
| Louisiana | 560 | $43,948 | $7,063 |
| Illinois | 1,609 | $43,810 | $7,998 |
| New Hampshire | 197 | $43,380 | $8,305 |
| New Jersey | 1,091 | $43,379 | $9,134 |
| Tennessee | 915 | $42,687 | $7,090 |
| West Virginia | 243 | $41,664 | $7,057 |
| Indiana | 622 | $41,029 | $7,650 |
| Missouri | 1,003 | $40,778 | $7,454 |
| Oklahoma | 793 | $40,259 | $7,313 |
| Georgia | 779 | $39,627 | $7,534 |
| Mississippi | 565 | $37,900 | $7,138 |
| South Dakota | 358 | $35,858 | $8,038 |
| Michigan | 1,016 | $35,586 | $7,603 |
| Maine | 144 | $35,365 | $7,651 |
| North Carolina | 1,350 | $35,170 | $7,484 |
| Connecticut | 440 | $34,526 | $9,460 |
| Oregon | 278 | $33,781 | $9,304 |
| Washington | 620 | $33,218 | $8,761 |
| Kansas | 999 | $32,568 | $7,440 |
| Massachusetts | 1,234 | $32,164 | $9,093 |
| Nebraska | 305 | $32,120 | $7,624 |
| Ohio | 1,375 | $31,409 | $7,215 |
| Iowa | 430 | $30,942 | $7,395 |
| Wisconsin | 616 | $30,329 | $7,767 |
| North Dakota | 352 | $30,240 | $8,162 |
| Idaho | 385 | $29,850 | $7,831 |
| Arkansas | 537 | $29,537 | $7,275 |
| Minnesota | 454 | $29,505 | $8,214 |
| Montana | 166 | $29,235 | $8,107 |
| Delaware | 204 | $27,216 | $8,453 |
| Vermont | 83 | $26,597 | $3,496 |
| Hawaii | 42 | $26,379 | $9,793 |
| Rhode Island | 73 | $23,735 | $8,619 |
Highest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Cjw Medical Center Richmond, VA | $210,001 | $7,314 |
| Medical City Fort Worth Fort Worth, TX | $171,088 | $7,670 |
| Grandview Medical Center Birmingham, AL | $157,546 | $6,914 |
| Good Samaritan Hospital San Jose, CA | $142,065 | $11,745 |
| Ascension St Vincent's Clay County Middleburg, FL | $139,366 | $7,696 |
| Medical City Denton Denton, TX | $137,738 | $7,670 |
| Flowers Hospital Dothan, AL | $133,506 | $7,295 |
| Medical City Dallas Dallas, TX | $132,014 | $7,645 |
| Doctors Medical Center Modesto, CA | $131,655 | $10,435 |
| Long Island Community Hospital Patchogue, NY | $130,929 | $9,483 |
Lowest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Aspirus Stevens Point Hospital Stevens Point, WI | $11,233 | $7,602 |
| Mary Imogene Bassett Hospital Cooperstown, NY | $11,913 | $9,640 |
| Mercyone Dubuque Medical Center Dubuque, IA | $12,130 | $7,746 |
| Aspirus Wausau Hospital Wausau, WI | $12,595 | $7,602 |
| Trinity Medical Ctr East &trinity Medical Ctr West Steubenville, OH | $12,781 | $7,229 |
| Saint Alphonsus Medical Center - Nampa Nampa, ID | $12,906 | $8,222 |
| Mercyone Siouxland Medical Center Sioux City, IA | $13,597 | $7,655 |
| St Luke's Magic Valley Rmc Twin Falls, ID | $14,718 | $7,961 |
| Bronson Methodist Hospital Kalamazoo, MI | $14,731 | $7,431 |
| Columbia Memorial Hospital Hudson, NY | $14,746 | $9,003 |
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.