Outpatient / APC 5232
APC 5232 · 787 hospitals · 27,623 services
Level 2 ICD and Similar Procedures
Hospital outpatient departments billed Medicare for 27,623 services in APC 5232 in 2024. They charged an average of $169,956; Medicare allowed $31,054 — a ratio of 5.5 to 1 — and paid $29,419 of it, the patient's coinsurance making up most of the rest. Average charges ranged from $40,145 to $642,827 across hospitals.
- 1Average charge $169,956
- 2Medicare allowed $31,054
- 3Reporting hospitals 787
- 4Services 27,623
By state
The average charge for this service was highest in Nevada ($321,594) and lowest in Vermont ($89,999). 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 | 167 | $321,594 | $33,845 |
| Texas | 1,980 | $236,796 | $28,976 |
| Colorado | 307 | $232,532 | $31,305 |
| Kentucky | 462 | $221,491 | $28,240 |
| South Carolina | 758 | $213,206 | $28,063 |
| California | 1,960 | $209,702 | $41,569 |
| New Jersey | 872 | $203,936 | $34,814 |
| Pennsylvania | 1,421 | $203,299 | $30,993 |
| Florida | 1,950 | $193,578 | $29,523 |
| Alabama | 386 | $191,112 | $26,988 |
| Arizona | 495 | $185,620 | $32,045 |
| Louisiana | 406 | $185,587 | $27,646 |
| Virginia | 917 | $180,764 | $29,287 |
| New Mexico | 105 | $177,452 | $28,507 |
| New York | 1,438 | $173,380 | $35,911 |
| District of Columbia | 120 | $171,631 | $32,975 |
| Wyoming | 39 | $161,438 | $32,016 |
| Utah | 166 | $161,373 | $29,786 |
| Tennessee | 761 | $160,863 | $27,173 |
| Georgia | 981 | $157,319 | $29,175 |
| Illinois | 1,271 | $156,704 | $30,701 |
| Michigan | 764 | $154,656 | $28,989 |
| South Dakota | 144 | $153,659 | $30,993 |
| Indiana | 734 | $151,006 | $29,820 |
| Oregon | 239 | $150,695 | $35,322 |
| Delaware | 210 | $148,144 | $32,900 |
| New Hampshire | 122 | $146,347 | $32,214 |
| Oklahoma | 502 | $140,084 | $27,938 |
| North Carolina | 899 | $137,454 | $29,130 |
| Maine | 80 | $132,344 | $29,204 |
| Missouri | 727 | $131,364 | $28,292 |
| Washington | 514 | $130,706 | $33,540 |
| Mississippi | 391 | $130,661 | $27,649 |
| Wisconsin | 471 | $130,122 | $30,074 |
| Idaho | 165 | $129,153 | $29,851 |
| West Virginia | 206 | $128,109 | $27,457 |
| Kansas | 350 | $124,639 | $28,697 |
| Nebraska | 336 | $122,463 | $29,489 |
| Ohio | 1,170 | $121,103 | $27,960 |
| North Dakota | 129 | $120,589 | $31,253 |
| Alaska | 29 | $119,120 | $34,183 |
| Minnesota | 478 | $119,100 | $31,832 |
| Hawaii | 56 | $113,535 | $37,646 |
| Montana | 136 | $112,899 | $31,040 |
| Arkansas | 487 | $110,042 | $27,815 |
| Massachusetts | 631 | $105,463 | $34,924 |
| Iowa | 354 | $105,299 | $28,530 |
| Connecticut | 259 | $97,724 | $36,228 |
| Rhode Island | 44 | $91,625 | $32,565 |
| Vermont | 34 | $89,999 | $15,114 |
Highest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Cedars-Sinai Medical Center Los Angeles, CA | $642,827 | $39,711 |
| Englewood Hospital Englewood, NJ | $592,224 | $35,804 |
| St David's South Austin Medical Center Austin, TX | $526,118 | $28,872 |
| Southern Hills Hospital and Medical Center Las Vegas, NV | $516,052 | $32,348 |
| Cjw Medical Center Richmond, VA | $512,798 | $28,240 |
| Henrico Doctors' Hospital Richmond, VA | $497,138 | $28,485 |
| St David's Medical Center Austin, TX | $491,572 | $28,324 |
| Round Rock Medical Center Round Rock, TX | $484,664 | $27,792 |
| Research Medical Center Kansas City, MO | $475,525 | $27,146 |
| Brookwood Baptist Medical Center Vestavia, AL | $473,869 | $25,043 |
Lowest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Cookeville Regional Medical Center Cookeville, TN | $40,145 | $30,088 |
| Crouse Hospital Syracuse, NY | $44,815 | $33,194 |
| Saint Joseph Hospital Lexington, KY | $45,204 | $26,176 |
| Aspirus Wausau Hospital Wausau, WI | $48,501 | $28,361 |
| Saint Joseph's Hospital of Atlanta, Inc Atlanta, GA | $49,890 | $29,474 |
| Emory University Hospital Atlanta, GA | $51,785 | $29,447 |
| Emory University Hospital Midtown Atlanta, GA | $54,159 | $28,136 |
| St Francis Hospital- Emory Healthcare Columbus, GA | $56,267 | $27,727 |
| Mercy Hospital Northwest Arkansas Rogers, AR | $57,783 | $26,899 |
| Beth Israel Deaconess Medical Center Boston, MA | $57,933 | $34,316 |
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.