Outpatient / APC 5431
APC 5431 · 1,588 hospitals · 131,191 services
Level 1 Nerve Procedures
Hospital outpatient departments billed Medicare for 131,191 services in APC 5431 in 2024. They charged an average of $12,596; Medicare allowed $1,776 — a ratio of 7.1 to 1 — and paid $1,408 of it, the patient's coinsurance making up most of the rest. Average charges ranged from $1,592 to $105,401 across hospitals.
- 1Average charge $12,596
- 2Medicare allowed $1,776
- 3Reporting hospitals 1,588
- 4Services 131,191
By state
The average charge for this service was highest in Nevada ($24,464) and lowest in Montana ($6,825). 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 | 309 | $24,464 | $2,054 |
| California | 6,886 | $19,391 | $2,395 |
| Florida | 4,338 | $18,605 | $1,725 |
| Texas | 10,679 | $18,063 | $1,686 |
| Georgia | 2,017 | $16,665 | $1,680 |
| District of Columbia | 149 | $16,127 | $1,965 |
| Colorado | 1,408 | $15,378 | $1,846 |
| Alabama | 1,956 | $14,549 | $1,567 |
| New Mexico | 1,070 | $14,426 | $1,778 |
| New Jersey | 2,052 | $14,367 | $2,031 |
| Arizona | 2,169 | $14,311 | $1,885 |
| New Hampshire | 973 | $13,987 | $1,771 |
| Indiana | 3,043 | $13,717 | $1,728 |
| South Carolina | 2,251 | $13,627 | $1,583 |
| Alaska | 160 | $13,624 | $2,082 |
| New York | 5,224 | $13,330 | $2,051 |
| Illinois | 5,448 | $12,903 | $1,808 |
| Pennsylvania | 7,129 | $12,623 | $1,719 |
| Oklahoma | 4,357 | $12,332 | $1,641 |
| Virginia | 3,356 | $12,264 | $1,694 |
| Kentucky | 1,882 | $12,253 | $1,663 |
| Utah | 1,384 | $12,207 | $1,723 |
| Tennessee | 2,044 | $12,036 | $1,502 |
| North Carolina | 3,822 | $11,910 | $1,695 |
| Louisiana | 3,359 | $11,748 | $1,602 |
| Washington | 2,550 | $11,648 | $1,975 |
| Connecticut | 492 | $11,459 | $2,135 |
| Oregon | 688 | $11,279 | $2,063 |
| Ohio | 7,570 | $10,568 | $1,609 |
| Missouri | 5,751 | $10,541 | $1,665 |
| Mississippi | 1,075 | $10,518 | $1,477 |
| Michigan | 3,552 | $10,315 | $1,681 |
| Iowa | 1,542 | $10,301 | $1,652 |
| South Dakota | 2,403 | $10,045 | $1,821 |
| Kansas | 2,706 | $9,910 | $1,662 |
| Wisconsin | 4,543 | $9,348 | $1,760 |
| Idaho | 1,575 | $8,830 | $1,716 |
| Nebraska | 1,235 | $8,764 | $1,655 |
| Wyoming | 345 | $8,707 | $1,865 |
| Delaware | 211 | $8,693 | $1,923 |
| North Dakota | 835 | $8,660 | $1,825 |
| West Virginia | 2,470 | $8,522 | $1,580 |
| Minnesota | 2,742 | $8,454 | $1,895 |
| Rhode Island | 335 | $8,355 | $1,934 |
| Vermont | 693 | $8,350 | $946 |
| Massachusetts | 5,753 | $8,267 | $2,067 |
| Hawaii | 170 | $7,957 | $2,247 |
| Arkansas | 2,796 | $7,705 | $1,661 |
| Maine | 936 | $7,302 | $1,752 |
| Montana | 750 | $6,825 | $1,832 |
Highest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| The Woodlands Specialty Hospital Spring, TX | $105,401 | $1,756 |
| Palmdale Regional Medical Center Palmdale, CA | $93,739 | $2,374 |
| HCA Florida Highlands Hospital Sebring, FL | $85,005 | $1,644 |
| Grandview Medical Center Birmingham, AL | $75,262 | $1,522 |
| HCA Florida Brandon Hospital Brandon, FL | $70,328 | $1,749 |
| HCA Florida West Hospital Pensacola, FL | $66,718 | $1,686 |
| Emanuel Medical Center Turlock, CA | $66,497 | $2,426 |
| HCA Florida Jfk Hospital Atlantis, FL | $66,291 | $1,749 |
| Tricities Hospital Hopewell, VA | $65,413 | $1,557 |
| Cedars-Sinai Medical Center Los Angeles, CA | $64,818 | $2,356 |
Lowest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Mary Free Bed Rehabilitation Hospital Grand Rapids, MI | $1,592 | $1,009 |
| Nicholas H Noyes Memorial Hospital Dansville, NY | $1,924 | $2,005 |
| The University of Vermont Health Network - Champl Plattsburgh, NY | $2,089 | $2,175 |
| Sweetwater Hospital Association Sweetwater, TN | $2,532 | $1,592 |
| Connally Memorial Medical Center Floresville, TX | $2,673 | $1,676 |
| Northeast Rehabilitation Hospital Salem, NH | $2,675 | $1,922 |
| Camc Charleston Surgical Hospital Charleston, WV | $2,818 | $1,570 |
| St Peters Health Helena, MT | $2,863 | $1,901 |
| Nmc Health Newton, KS | $2,896 | $1,648 |
| Warren General Hospital Warren, PA | $3,037 | $2,035 |
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.