Outpatient / APC 5224
APC 5224 · 550 hospitals · 17,266 services
Level 4 Pacemaker and Similar Procedures
Hospital outpatient departments billed Medicare for 17,266 services in APC 5224 in 2024. They charged an average of $108,399; Medicare allowed $18,636 — a ratio of 5.8 to 1 — and paid $17,003 of it, the patient's coinsurance making up most of the rest. Average charges ranged from $23,683 to $420,815 across hospitals.
- 1Average charge $108,399
- 2Medicare allowed $18,636
- 3Reporting hospitals 550
- 4Services 17,266
By state
The average charge for this service was highest in Nevada ($191,409) and lowest in Hawaii ($58,415). 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 | 129 | $191,409 | $20,866 |
| South Carolina | 486 | $158,145 | $16,662 |
| Texas | 1,323 | $146,508 | $17,405 |
| Kentucky | 288 | $137,565 | $16,773 |
| Florida | 1,253 | $133,682 | $17,457 |
| California | 1,602 | $132,832 | $24,590 |
| Colorado | 301 | $129,366 | $18,553 |
| Arizona | 475 | $128,168 | $19,099 |
| Utah | 105 | $122,761 | $17,617 |
| District of Columbia | 67 | $118,276 | $19,888 |
| Alabama | 273 | $116,319 | $16,248 |
| Pennsylvania | 606 | $115,363 | $18,378 |
| New York | 793 | $114,849 | $21,483 |
| New Mexico | 95 | $113,138 | $17,111 |
| New Jersey | 436 | $111,981 | $20,707 |
| West Virginia | 101 | $109,765 | $16,003 |
| Indiana | 337 | $106,217 | $17,705 |
| Louisiana | 171 | $105,410 | $16,183 |
| South Dakota | 72 | $105,382 | $18,828 |
| Virginia | 568 | $99,573 | $17,513 |
| Tennessee | 570 | $98,441 | $16,396 |
| Illinois | 653 | $96,864 | $18,317 |
| Maine | 75 | $96,355 | $17,563 |
| Idaho | 169 | $95,674 | $17,970 |
| New Hampshire | 92 | $95,523 | $19,095 |
| North Carolina | 552 | $92,266 | $17,241 |
| Alaska | 50 | $91,063 | $20,120 |
| Wyoming | 15 | $89,782 | $19,443 |
| Oregon | 156 | $89,059 | $20,943 |
| Georgia | 582 | $88,765 | $17,468 |
| Oklahoma | 302 | $87,007 | $16,630 |
| Michigan | 382 | $86,406 | $17,619 |
| Minnesota | 374 | $85,580 | $18,894 |
| Missouri | 505 | $83,923 | $17,032 |
| Mississippi | 242 | $83,863 | $16,432 |
| Delaware | 79 | $83,761 | $19,490 |
| Washington | 389 | $83,596 | $20,037 |
| Wisconsin | 363 | $81,805 | $17,898 |
| Kansas | 213 | $80,602 | $17,000 |
| North Dakota | 60 | $79,801 | $18,614 |
| Nebraska | 214 | $79,256 | $17,448 |
| Ohio | 469 | $72,419 | $16,851 |
| Arkansas | 349 | $69,572 | $16,549 |
| Connecticut | 131 | $69,555 | $21,813 |
| Massachusetts | 331 | $65,599 | $20,825 |
| Iowa | 240 | $64,147 | $17,128 |
| Montana | 141 | $63,678 | $18,291 |
| Vermont | 19 | $62,285 | $9,905 |
| Rhode Island | 24 | $61,846 | $18,973 |
| Hawaii | 44 | $58,415 | $22,143 |
Highest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Good Samaritan Hospital San Jose, CA | $420,815 | $27,359 |
| Grandview Medical Center Birmingham, AL | $366,747 | $16,167 |
| Grand Strand Regional Medical Center Myrtle Beach, SC | $351,431 | $16,654 |
| Cjw Medical Center Richmond, VA | $337,330 | $16,739 |
| Trident Medical Center Charleston, SC | $308,842 | $16,776 |
| HCA Houston Healthcare Kingwood Kingwood, TX | $306,007 | $18,027 |
| St Mark's Hospital Salt Lake City, UT | $301,476 | $17,417 |
| St David's Medical Center Austin, TX | $299,937 | $17,113 |
| Cedars-Sinai Medical Center Los Angeles, CA | $298,422 | $23,891 |
| Delray Medical Center Delray Beach, FL | $292,771 | $14,116 |
Lowest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Crouse Hospital Syracuse, NY | $23,683 | $20,608 |
| Emory University Hospital Atlanta, GA | $34,452 | $18,042 |
| Saint Joseph's Hospital of Atlanta, Inc Atlanta, GA | $34,697 | $17,470 |
| Robert Packer Hospital Sayre, PA | $35,655 | $17,485 |
| Kaleida Health Buffalo, NY | $35,744 | $20,608 |
| Silver Cross Hospital and Medical Centers New Lenox, IL | $37,926 | $18,457 |
| St Francis Hospital- Emory Healthcare Columbus, GA | $39,691 | $16,435 |
| Memorial Hermann Memorial City Medical Center Houston, TX | $40,451 | $18,027 |
| Prov Sacred Hrt Med Ctr & Childs Hosp. Spokane, WA | $40,626 | $19,509 |
| South Shore Hospital South Weymouth, MA | $41,321 | $20,874 |
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.