Outpatient / APC 5378
APC 5378 · 185 hospitals · 7,242 services
Level 8 Urology and Related Services
Hospital outpatient departments billed Medicare for 7,242 services in APC 5378 in 2024. They charged an average of $100,071; Medicare allowed $18,997 — a ratio of 5.3 to 1 — and paid $17,367 of it, the patient's coinsurance making up most of the rest. Average charges ranged from $32,275 to $305,383 across hospitals.
- 1Average charge $100,071
- 2Medicare allowed $18,997
- 3Reporting hospitals 185
- 4Services 7,242
By state
The average charge for this service was highest in Nevada ($187,907) and lowest in Idaho ($48,166). 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 | 31 | $187,907 | $21,097 |
| Kentucky | 104 | $160,438 | $17,557 |
| Texas | 726 | $134,044 | $17,886 |
| Colorado | 108 | $129,689 | $19,209 |
| Pennsylvania | 246 | $129,339 | $19,072 |
| Alabama | 165 | $128,932 | $15,852 |
| Florida | 673 | $117,970 | $17,999 |
| California | 629 | $115,416 | $25,389 |
| Indiana | 128 | $112,314 | $17,861 |
| Oklahoma | 81 | $107,425 | $16,943 |
| Illinois | 201 | $107,074 | $18,715 |
| Arizona | 234 | $106,333 | $19,447 |
| South Carolina | 192 | $105,335 | $16,806 |
| Washington | 132 | $105,136 | $20,416 |
| Delaware | 16 | $100,650 | $20,205 |
| Georgia | 259 | $96,823 | $17,916 |
| Wisconsin | 66 | $96,008 | $18,575 |
| New Jersey | 136 | $95,219 | $21,455 |
| North Carolina | 334 | $91,849 | $17,605 |
| Louisiana | 172 | $91,383 | $16,210 |
| Tennessee | 223 | $91,221 | $15,904 |
| Kansas | 78 | $90,704 | $17,291 |
| New York | 358 | $85,133 | $21,945 |
| Ohio | 288 | $83,837 | $16,953 |
| West Virginia | 39 | $81,711 | $16,699 |
| Maine | 22 | $77,675 | $17,504 |
| District of Columbia | 30 | $76,096 | $20,245 |
| South Dakota | 30 | $74,689 | $19,245 |
| Oregon | 60 | $73,237 | $21,930 |
| Iowa | 46 | $73,233 | $16,643 |
| New Hampshire | 32 | $72,879 | $19,422 |
| Missouri | 156 | $71,511 | $17,314 |
| Virginia | 131 | $69,928 | $18,132 |
| Michigan | 135 | $68,404 | $17,576 |
| Mississippi | 62 | $67,130 | $16,603 |
| Nebraska | 65 | $66,673 | $18,111 |
| Utah | 62 | $66,059 | $17,600 |
| Connecticut | 45 | $61,867 | $22,048 |
| Arkansas | 119 | $60,777 | $15,297 |
| Massachusetts | 265 | $60,018 | $21,398 |
| Rhode Island | 13 | $55,829 | $20,421 |
| Montana | 44 | $53,831 | $18,989 |
| Minnesota | 247 | $52,687 | $20,202 |
| Idaho | 24 | $48,166 | $18,508 |
Highest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| St David's South Austin Medical Center Austin, TX | $305,383 | $17,715 |
| NYU Langone Hospitals New York, NY | $293,855 | $22,657 |
| HCA Houston Healthcare Medical Center Houston, TX | $260,868 | $17,645 |
| Grandview Medical Center Birmingham, AL | $237,955 | $14,859 |
| Baptist Health Paducah Paducah, KY | $233,399 | $18,413 |
| Houston Methodist Hospital Houston, TX | $208,662 | $18,661 |
| Cedars-Sinai Medical Center Los Angeles, CA | $203,273 | $24,732 |
| Stanford Health Care Stanford, CA | $202,294 | $28,322 |
| Sunrise Hospital and Medical Center Las Vegas, NV | $200,654 | $21,548 |
| Geisinger Medical Center Danville, PA | $200,217 | $17,976 |
Lowest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Lincoln Surgical Hospital Lincoln, NE | $32,275 | $17,972 |
| Uva Health Sciences Center Charlottesville, VA | $34,014 | $17,805 |
| Cape Cod Hospital Hyannis, MA | $34,031 | $21,608 |
| Boston Medical Center Corporation- Boston, MA | $37,150 | $21,608 |
| Albany Medical Center Hospital Albany, NY | $37,382 | $21,333 |
| Billings Clinic Hospital Billings, MT | $38,185 | $18,868 |
| Lahey Hospital & Medical Center, Burlington Burlington, MA | $42,049 | $21,608 |
| Baylor Scott and White Surgical Hospital Fortworth Fort Worth, TX | $44,683 | $17,817 |
| UNC Hospitals Chapel Hill, NC | $46,573 | $17,306 |
| North Shore Medical Center - Salem, MA | $47,580 | $19,792 |
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.