Outpatient / APC 5302
APC 5302 · 1,991 hospitals · 211,634 services
Level 2 Upper GI Procedures
Hospital outpatient departments billed Medicare for 211,634 services in APC 5302 in 2024. They charged an average of $13,587; Medicare allowed $1,814 — a ratio of 7.5 to 1 — and paid $1,444 of it, the patient's coinsurance making up most of the rest. Average charges ranged from $2,622 to $73,960 across hospitals.
- 1Average charge $13,587
- 2Medicare allowed $1,814
- 3Reporting hospitals 1,991
- 4Services 211,634
By state
The average charge for this service was highest in Nevada ($24,222) and lowest in Utah ($8,000). 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 | 835 | $24,222 | $2,027 |
| California | 17,701 | $19,034 | $2,419 |
| Florida | 14,015 | $18,929 | $1,708 |
| Alaska | 329 | $17,611 | $2,006 |
| New Jersey | 4,801 | $16,923 | $2,014 |
| Alabama | 4,293 | $16,696 | $1,559 |
| Texas | 13,449 | $16,236 | $1,688 |
| Mississippi | 1,565 | $15,381 | $1,481 |
| Pennsylvania | 9,403 | $15,366 | $1,761 |
| New York | 10,991 | $15,077 | $2,089 |
| Georgia | 5,506 | $14,925 | $1,689 |
| Colorado | 3,383 | $14,762 | $1,819 |
| Arizona | 4,398 | $14,511 | $1,861 |
| South Carolina | 4,890 | $14,055 | $1,625 |
| Oklahoma | 3,987 | $14,050 | $1,632 |
| Virginia | 7,185 | $13,852 | $1,691 |
| Illinois | 9,481 | $13,666 | $1,792 |
| Kentucky | 4,013 | $13,357 | $1,639 |
| Indiana | 5,452 | $13,048 | $1,712 |
| New Hampshire | 2,049 | $12,954 | $1,858 |
| New Mexico | 939 | $12,127 | $1,729 |
| Louisiana | 2,498 | $11,957 | $1,583 |
| Wisconsin | 4,764 | $11,645 | $1,748 |
| Hawaii | 470 | $11,560 | $2,150 |
| Tennessee | 4,494 | $11,319 | $1,592 |
| North Carolina | 6,790 | $11,289 | $1,687 |
| Washington | 4,087 | $10,814 | $1,935 |
| Kansas | 3,118 | $10,803 | $1,651 |
| Wyoming | 227 | $10,773 | $1,863 |
| Connecticut | 2,162 | $10,696 | $2,108 |
| Minnesota | 4,542 | $10,644 | $1,861 |
| Iowa | 2,361 | $10,604 | $1,637 |
| Ohio | 8,663 | $10,363 | $1,607 |
| District of Columbia | 1,161 | $10,129 | $1,918 |
| Nebraska | 1,627 | $10,076 | $1,700 |
| Missouri | 6,330 | $9,712 | $1,657 |
| West Virginia | 1,874 | $9,603 | $1,594 |
| South Dakota | 1,469 | $9,405 | $1,800 |
| Oregon | 1,733 | $9,198 | $2,015 |
| North Dakota | 1,160 | $9,037 | $1,794 |
| Vermont | 377 | $8,946 | $1,027 |
| Michigan | 5,146 | $8,683 | $1,680 |
| Rhode Island | 704 | $8,553 | $1,919 |
| Delaware | 730 | $8,494 | $1,902 |
| Arkansas | 1,769 | $8,420 | $1,634 |
| Maine | 1,064 | $8,415 | $1,741 |
| Massachusetts | 8,056 | $8,334 | $2,031 |
| Idaho | 1,429 | $8,277 | $1,765 |
| Montana | 1,335 | $8,005 | $1,811 |
| Utah | 2,819 | $8,000 | $1,675 |
Highest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Rio Grande Regional Hospital Mcallen, TX | $73,960 | $1,651 |
| Flowers Hospital Dothan, AL | $66,416 | $1,584 |
| Capital Health Regional Medical Center Trenton, NJ | $66,107 | $1,870 |
| UCLA West Valley Medical Center West Hills, CA | $57,895 | $2,339 |
| Good Samaritan Hospital San Jose, CA | $54,052 | $2,679 |
| HCA Healthone Sky Ridge Lone Tree, CO | $50,978 | $1,784 |
| HCA Florida Largo Hospital Largo, FL | $50,938 | $1,724 |
| HCA Florida Trinity Hospital Trinity, FL | $50,808 | $1,724 |
| Singing River Gulfport Gulfport, MS | $49,495 | $1,535 |
| HCA Florida Fort Walton-Destin Hospital Fort Walton Beach, FL | $49,448 | $1,713 |
Lowest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Niagara Falls Memorial Medical Center Niagara Falls, NY | $2,622 | $2,017 |
| Community Hospital Inc Tallassee, AL | $2,929 | $1,598 |
| Salina Surgical Hospital Salina, KS | $2,976 | $1,620 |
| Mcalester Regional Health Center Mcalester, OK | $2,976 | $1,731 |
| Mymichigan Medical Center Clare Clare, MI | $3,017 | $1,658 |
| Davis Medical Center Elkins, WV | $3,034 | $1,588 |
| Johnson Regional Medical Center Clarksville, AR | $3,101 | $1,605 |
| Olean General Hospital Olean, NY | $3,223 | $2,047 |
| Clifton Springs Hospital and Clinic Clifton Springs, NY | $3,254 | $1,991 |
| Nmc Health Newton, KS | $3,351 | $1,531 |
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.