Outpatient / APC 5376
APC 5376 · 575 hospitals · 22,044 services
Level 6 Urology and Related Services
Hospital outpatient departments billed Medicare for 22,044 services in APC 5376 in 2024. They charged an average of $54,267; Medicare allowed $8,871 — a ratio of 6.1 to 1 — and paid $7,248 of it, the patient's coinsurance making up most of the rest. Average charges ranged from $10,003 to $213,271 across hospitals.
- 1Average charge $54,267
- 2Medicare allowed $8,871
- 3Reporting hospitals 575
- 4Services 22,044
By state
The average charge for this service was highest in Nevada ($85,616) and lowest in Massachusetts ($29,140). 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 | 106 | $85,616 | $9,815 |
| Florida | 1,861 | $76,533 | $8,253 |
| Colorado | 431 | $74,683 | $8,942 |
| South Carolina | 494 | $69,343 | $7,942 |
| California | 2,256 | $68,071 | $11,587 |
| Arizona | 634 | $64,874 | $8,957 |
| Texas | 1,411 | $64,089 | $8,147 |
| Kentucky | 304 | $59,711 | $7,885 |
| Oklahoma | 242 | $59,171 | $7,972 |
| Virginia | 707 | $57,027 | $8,345 |
| Pennsylvania | 713 | $56,837 | $8,576 |
| Indiana | 581 | $56,782 | $8,361 |
| New York | 1,664 | $55,845 | $10,142 |
| Kansas | 324 | $52,692 | $7,895 |
| Tennessee | 683 | $51,035 | $7,504 |
| Washington | 508 | $50,787 | $9,374 |
| Alabama | 185 | $50,610 | $7,740 |
| Illinois | 671 | $50,589 | $8,694 |
| Georgia | 794 | $49,397 | $8,304 |
| New Mexico | 30 | $48,213 | $8,170 |
| New Hampshire | 71 | $47,830 | $9,010 |
| West Virginia | 157 | $47,381 | $7,841 |
| New Jersey | 574 | $45,087 | $9,718 |
| Michigan | 476 | $43,044 | $8,113 |
| Vermont | 47 | $41,852 | $5,530 |
| Ohio | 1,056 | $41,807 | $7,909 |
| Louisiana | 377 | $41,574 | $7,617 |
| Wisconsin | 314 | $41,315 | $8,444 |
| District of Columbia | 133 | $41,152 | $9,244 |
| North Carolina | 734 | $41,042 | $8,175 |
| South Dakota | 139 | $40,143 | $8,851 |
| Utah | 131 | $39,994 | $8,173 |
| Iowa | 156 | $39,251 | $7,981 |
| Maine | 35 | $38,997 | $8,534 |
| Oregon | 202 | $38,506 | $9,666 |
| Hawaii | 30 | $36,967 | $10,835 |
| Minnesota | 413 | $36,967 | $9,148 |
| Nebraska | 303 | $35,018 | $8,313 |
| North Dakota | 79 | $34,812 | $8,894 |
| Missouri | 505 | $33,799 | $8,077 |
| Mississippi | 106 | $32,891 | $7,646 |
| Idaho | 112 | $32,622 | $8,246 |
| Arkansas | 308 | $32,535 | $7,909 |
| Connecticut | 98 | $32,305 | $10,327 |
| Montana | 106 | $31,982 | $8,838 |
| Rhode Island | 81 | $30,451 | $9,248 |
| Delaware | 32 | $29,945 | $9,240 |
| Massachusetts | 573 | $29,140 | $9,806 |
Highest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Henrico Doctors' Hospital Richmond, VA | $213,271 | $7,863 |
| St Francis Hospital Memphis, TN | $186,348 | $5,974 |
| Brookwood Baptist Medical Center Vestavia, AL | $179,221 | $7,368 |
| HCA Florida St Lucie Hospital Port Saint Lucie, FL | $178,355 | $8,214 |
| HCA Florida Oak Hill Hospital Brooksville, FL | $178,137 | $8,343 |
| Grand Strand Regional Medical Center Myrtle Beach, SC | $165,269 | $7,890 |
| Adventhealth Heart of Florida Davenport, FL | $163,697 | $8,343 |
| HCA Healthone Sky Ridge Lone Tree, CO | $161,040 | $8,767 |
| HCA Florida St Petersburg Hospital Saint Petersburg, FL | $151,466 | $8,343 |
| HCA Florida West Hospital Pensacola, FL | $142,956 | $8,343 |
Lowest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Bothwell Regional Health Center Sedalia, MO | $10,003 | $8,614 |
| East Alabama Medical Center Opelika, AL | $12,954 | $7,965 |
| West Tennessee Healthcare Henry County Hospital Paris, TN | $14,902 | $7,597 |
| Fisher-Titus Hospital Norwalk, OH | $17,276 | $7,880 |
| Kell West Regional Hospital Wichita Falls, TX | $17,379 | $7,874 |
| Daviess Community Hospital Washington, IN | $17,546 | $8,211 |
| Lahey Hospital & Medical Center, Burlington Burlington, MA | $17,594 | $9,886 |
| Cape Cod Hospital Hyannis, MA | $18,222 | $9,620 |
| Auburn Community Hospital Auburn, NY | $18,240 | $10,451 |
| St Bernards Medical Center Jonesboro, AR | $18,390 | $7,771 |
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.