Outpatient / APC 5375
APC 5375 · 1,921 hospitals · 153,437 services
Level 5 Urology and Related Services
Hospital outpatient departments billed Medicare for 153,437 services in APC 5375 in 2024. They charged an average of $32,824; Medicare allowed $4,935 — a ratio of 6.7 to 1 — and paid $3,919 of it, the patient's coinsurance making up most of the rest. Average charges ranged from $5,734 to $179,389 across hospitals.
- 1Average charge $32,824
- 2Medicare allowed $4,935
- 3Reporting hospitals 1,921
- 4Services 153,437
By state
The average charge for this service was highest in Nevada ($55,697) and lowest in Rhode Island ($14,245). 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 | 876 | $55,697 | $5,493 |
| Florida | 10,096 | $51,337 | $4,635 |
| California | 11,977 | $51,167 | $6,598 |
| South Carolina | 4,135 | $38,828 | $4,411 |
| Arizona | 3,781 | $38,787 | $5,059 |
| Texas | 9,143 | $38,562 | $4,599 |
| New Mexico | 874 | $36,607 | $4,700 |
| Colorado | 2,110 | $36,568 | $4,980 |
| Pennsylvania | 7,182 | $36,329 | $4,764 |
| Georgia | 4,699 | $35,322 | $4,575 |
| Illinois | 6,293 | $33,825 | $4,885 |
| Virginia | 4,547 | $33,253 | $4,632 |
| Alabama | 1,986 | $32,806 | $4,224 |
| Oklahoma | 2,386 | $32,602 | $4,394 |
| Indiana | 3,737 | $32,400 | $4,664 |
| Washington | 3,282 | $32,230 | $5,291 |
| Alaska | 392 | $31,397 | $5,541 |
| District of Columbia | 557 | $30,469 | $5,208 |
| New Jersey | 4,455 | $29,528 | $5,526 |
| Kansas | 2,211 | $29,140 | $4,506 |
| New Hampshire | 1,064 | $28,668 | $5,033 |
| Kentucky | 2,148 | $28,662 | $4,486 |
| New York | 8,528 | $28,292 | $5,664 |
| North Carolina | 5,559 | $27,826 | $4,595 |
| Ohio | 6,657 | $26,980 | $4,333 |
| Louisiana | 2,104 | $26,800 | $4,236 |
| West Virginia | 1,227 | $26,465 | $4,392 |
| Utah | 1,810 | $26,362 | $4,654 |
| Tennessee | 3,602 | $26,306 | $4,144 |
| Missouri | 3,267 | $25,669 | $4,506 |
| Nebraska | 1,327 | $25,420 | $4,664 |
| Wisconsin | 3,359 | $25,384 | $4,757 |
| Mississippi | 1,204 | $25,275 | $4,314 |
| Oregon | 1,671 | $25,079 | $5,558 |
| Wyoming | 368 | $23,537 | $5,142 |
| Michigan | 4,545 | $22,685 | $4,597 |
| Hawaii | 378 | $22,492 | $5,959 |
| Idaho | 1,118 | $22,008 | $4,711 |
| Iowa | 2,201 | $21,940 | $4,530 |
| South Dakota | 1,295 | $21,901 | $4,938 |
| Maine | 787 | $21,768 | $4,783 |
| Minnesota | 2,997 | $21,671 | $5,065 |
| Delaware | 637 | $21,429 | $5,147 |
| Connecticut | 1,775 | $21,291 | $5,724 |
| North Dakota | 678 | $20,263 | $4,911 |
| Arkansas | 1,829 | $19,342 | $4,397 |
| Massachusetts | 4,818 | $19,105 | $5,532 |
| Montana | 949 | $18,788 | $4,846 |
| Vermont | 326 | $18,115 | $2,441 |
| Rhode Island | 479 | $14,245 | $5,229 |
Highest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Northbay Medical Center Fairfield, CA | $179,389 | $7,335 |
| HCA Florida Fort Walton-Destin Hospital Fort Walton Beach, FL | $138,181 | $4,687 |
| Regional Medical Center of San Jose San Jose, CA | $135,664 | $7,286 |
| HCA Florida Fawcett Hospital Port Charlotte, FL | $130,515 | $4,687 |
| HCA Healthone Sky Ridge Lone Tree, CO | $130,258 | $4,861 |
| Oviedo Medical Center Oviedo, FL | $125,347 | $4,687 |
| HCA Florida St Lucie Hospital Port Saint Lucie, FL | $125,296 | $4,620 |
| Cjw Medical Center Richmond, VA | $123,987 | $4,382 |
| HCA Florida Lake Monroe Hospital Sanford, FL | $121,030 | $4,687 |
| Doctors Hospital Augusta, GA | $119,310 | $4,270 |
Lowest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Erie County Medical Center Buffalo, NY | $5,734 | $5,292 |
| Southwest General Health Center Middleburg Heights, OH | $6,250 | $1,540 |
| Mcalester Regional Health Center Mcalester, OK | $6,256 | $4,706 |
| Morristown Hamblen Hospital Association Morristown, TN | $7,352 | $4,267 |
| Kansas Medical Center LLC Andover, KS | $7,664 | $4,384 |
| Beth Israel Deaconess Hospital-Milton Inc Milton, MA | $8,112 | $5,557 |
| Cumberland Medical Center Crossville, TN | $8,222 | $4,570 |
| Cambridge Health Alliance Cambridge, MA | $8,251 | $5,557 |
| Marshall Medical Centers South Campus Boaz, AL | $8,262 | $4,027 |
| Olean General Hospital Olean, NY | $8,403 | $5,876 |
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.