Outpatient / APC 5374
APC 5374 · 1,986 hospitals · 156,802 services
Level 4 Urology and Related Services
Hospital outpatient departments billed Medicare for 156,802 services in APC 5374 in 2024. They charged an average of $23,669; Medicare allowed $3,313 — a ratio of 7.1 to 1 — and paid $2,630 of it, the patient's coinsurance making up most of the rest. Average charges ranged from $4,264 to $136,595 across hospitals.
- 1Average charge $23,669
- 2Medicare allowed $3,313
- 3Reporting hospitals 1,986
- 4Services 156,802
By state
The average charge for this service was highest in Nevada ($47,963) and lowest in Rhode Island ($10,492). 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 | 732 | $47,963 | $3,701 |
| Florida | 9,280 | $36,684 | $3,131 |
| California | 10,344 | $36,378 | $4,418 |
| Alabama | 2,486 | $31,204 | $2,886 |
| Texas | 9,185 | $31,008 | $3,096 |
| South Carolina | 3,960 | $30,163 | $2,978 |
| Arizona | 3,883 | $29,259 | $3,394 |
| Georgia | 4,296 | $27,163 | $3,092 |
| Oklahoma | 3,193 | $26,898 | $2,982 |
| New Mexico | 668 | $26,116 | $3,182 |
| Pennsylvania | 7,317 | $25,570 | $3,212 |
| Colorado | 1,790 | $25,416 | $3,349 |
| Mississippi | 2,002 | $23,835 | $2,915 |
| Illinois | 6,856 | $23,744 | $3,289 |
| Indiana | 4,041 | $23,462 | $3,144 |
| District of Columbia | 423 | $22,718 | $3,526 |
| Alaska | 314 | $22,341 | $3,679 |
| Washington | 3,412 | $22,173 | $3,587 |
| Virginia | 4,199 | $21,969 | $3,117 |
| Kansas | 2,032 | $21,253 | $3,049 |
| New Jersey | 5,417 | $21,241 | $3,731 |
| Tennessee | 3,746 | $20,897 | $2,841 |
| Louisiana | 2,772 | $20,743 | $2,848 |
| Kentucky | 2,865 | $20,570 | $3,004 |
| New York | 9,707 | $20,339 | $3,837 |
| Wyoming | 297 | $20,047 | $3,474 |
| Nebraska | 1,404 | $19,767 | $3,143 |
| New Hampshire | 1,026 | $19,531 | $3,400 |
| North Carolina | 5,256 | $19,065 | $3,097 |
| Oregon | 1,395 | $18,927 | $3,761 |
| Ohio | 6,753 | $18,813 | $2,945 |
| Missouri | 3,619 | $18,762 | $3,021 |
| Wisconsin | 3,283 | $18,304 | $3,202 |
| Iowa | 2,029 | $17,564 | $3,049 |
| West Virginia | 1,514 | $17,394 | $2,948 |
| Michigan | 5,032 | $16,877 | $3,076 |
| Hawaii | 390 | $16,280 | $3,977 |
| Arkansas | 2,160 | $16,004 | $2,980 |
| Connecticut | 1,843 | $15,852 | $3,873 |
| Minnesota | 2,728 | $15,279 | $3,406 |
| Utah | 1,224 | $15,209 | $3,139 |
| Vermont | 417 | $14,204 | $1,714 |
| Delaware | 652 | $14,096 | $3,471 |
| Maine | 950 | $14,059 | $3,166 |
| Idaho | 899 | $13,926 | $3,187 |
| South Dakota | 1,318 | $13,922 | $3,327 |
| Massachusetts | 5,439 | $13,103 | $3,723 |
| Montana | 989 | $13,029 | $3,284 |
| North Dakota | 739 | $12,831 | $3,319 |
| Rhode Island | 524 | $10,492 | $3,518 |
Highest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Northbay Medical Center Fairfield, CA | $136,595 | $5,016 |
| HCA Florida Ocala Hospital Ocala, FL | $111,264 | $2,878 |
| HCA Florida Fort Walton-Destin Hospital Fort Walton Beach, FL | $110,534 | $3,158 |
| Palmdale Regional Medical Center Palmdale, CA | $105,015 | $4,154 |
| Alliancehealth Durant Durant, OK | $104,749 | $2,981 |
| HCA Florida North Florida Hospital Gainesville, FL | $103,005 | $3,158 |
| HCA Florida St Petersburg Hospital Saint Petersburg, FL | $95,802 | $3,158 |
| HCA Florida Englewood Hospital Englewood, FL | $93,402 | $3,131 |
| HCA Healthone Sky Ridge Lone Tree, CO | $90,321 | $3,319 |
| HCA Florida St Lucie Hospital Port Saint Lucie, FL | $90,106 | $3,158 |
Lowest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Erie County Medical Center Buffalo, NY | $4,264 | $3,696 |
| St John's Riverside Hospital Yonkers, NY | $4,448 | $3,967 |
| Leonard J Chabert Medical Center Houma, LA | $5,436 | $2,898 |
| Mcalester Regional Health Center Mcalester, OK | $5,638 | $3,171 |
| South Shore Hospital South Weymouth, MA | $5,886 | $3,704 |
| Arkansas Surgical Hospital No Little Rock, AR | $5,889 | $2,935 |
| Beth Israel Deaconess Hospital-Milton Inc Milton, MA | $6,014 | $3,744 |
| Nicholas H Noyes Memorial Hospital Dansville, NY | $6,118 | $3,696 |
| Olean General Hospital Olean, NY | $6,177 | $3,886 |
| Mount Auburn Hospital Cambridge, MA | $6,265 | $3,653 |
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.