Outpatient / APC 5465
APC 5465 · 614 hospitals · 21,835 services
Level 5 Neurostimulator and Related Procedures
Hospital outpatient departments billed Medicare for 21,835 services in APC 5465 in 2024. They charged an average of $139,881; Medicare allowed $28,488 — a ratio of 4.9 to 1 — and paid $26,853 of it, the patient's coinsurance making up most of the rest. Average charges ranged from $35,589 to $617,038 across hospitals.
- 1Average charge $139,881
- 2Medicare allowed $28,488
- 3Reporting hospitals 614
- 4Services 21,835
By state
The average charge for this service was highest in Texas ($207,360) and lowest in Rhode Island ($63,200). 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 |
|---|---|---|---|
| Texas | 2,306 | $207,360 | $27,224 |
| Colorado | 320 | $195,594 | $29,347 |
| Arizona | 563 | $174,272 | $30,215 |
| Virginia | 633 | $167,797 | $26,978 |
| Alaska | 29 | $167,451 | $32,266 |
| Kentucky | 362 | $167,293 | $26,288 |
| Alabama | 360 | $165,260 | $24,645 |
| Florida | 1,569 | $162,357 | $27,468 |
| Oklahoma | 567 | $161,132 | $26,410 |
| Nevada | 103 | $159,577 | $33,847 |
| Pennsylvania | 1,064 | $157,427 | $28,723 |
| California | 1,049 | $155,717 | $38,936 |
| New York | 810 | $155,401 | $33,459 |
| New Jersey | 296 | $154,950 | $32,923 |
| South Carolina | 722 | $151,030 | $25,978 |
| Delaware | 110 | $145,888 | $30,800 |
| New Hampshire | 108 | $136,136 | $30,161 |
| Georgia | 572 | $134,886 | $27,182 |
| Illinois | 632 | $133,747 | $29,001 |
| Indiana | 461 | $131,997 | $27,630 |
| Idaho | 187 | $129,713 | $28,254 |
| Maine | 74 | $129,293 | $27,790 |
| New Mexico | 66 | $123,027 | $28,111 |
| Missouri | 672 | $120,496 | $26,643 |
| Utah | 349 | $119,761 | $27,663 |
| Louisiana | 451 | $117,662 | $25,806 |
| North Carolina | 931 | $115,792 | $27,018 |
| Kansas | 563 | $113,999 | $26,636 |
| South Dakota | 296 | $113,815 | $29,138 |
| Tennessee | 582 | $110,985 | $25,361 |
| Washington | 315 | $109,624 | $31,394 |
| Ohio | 997 | $106,440 | $26,077 |
| District of Columbia | 80 | $105,720 | $30,185 |
| Wyoming | 35 | $104,711 | $30,493 |
| Connecticut | 108 | $97,067 | $34,415 |
| West Virginia | 277 | $95,732 | $25,819 |
| Hawaii | 30 | $94,259 | $35,854 |
| Michigan | 453 | $93,652 | $26,729 |
| Wisconsin | 356 | $92,673 | $28,134 |
| North Dakota | 78 | $89,482 | $29,106 |
| Massachusetts | 469 | $88,393 | $33,054 |
| Oregon | 157 | $88,094 | $33,230 |
| Arkansas | 296 | $88,048 | $26,471 |
| Montana | 176 | $87,855 | $28,993 |
| Nebraska | 198 | $87,612 | $27,899 |
| Iowa | 258 | $85,139 | $27,528 |
| Vermont | 12 | $83,872 | $6,529 |
| Minnesota | 404 | $79,691 | $30,075 |
| Mississippi | 304 | $75,327 | $25,397 |
| Rhode Island | 25 | $63,200 | $30,233 |
Highest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Medical City Fort Worth Fort Worth, TX | $617,038 | $27,952 |
| Medical City Plano Plano, TX | $465,920 | $27,863 |
| HCA Healthone Swedish Englewood, CO | $439,455 | $29,473 |
| North Austin Medical Center Austin, TX | $433,320 | $26,902 |
| NYU Langone Hospitals New York, NY | $420,885 | $34,537 |
| Grandview Medical Center Birmingham, AL | $399,334 | $25,811 |
| Brookwood Baptist Medical Center Vestavia, AL | $389,868 | $24,638 |
| St David's Medical Center Austin, TX | $387,463 | $27,253 |
| Penn State Health Holy Spirit Medical Center Camp Hill, PA | $383,135 | $28,032 |
| Sierra Medical Center El Paso, TX | $375,762 | $25,793 |
Lowest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Och Regional Medical Center Starkville, MS | $35,589 | $25,287 |
| Bronson Methodist Hospital Kalamazoo, MI | $41,326 | $26,334 |
| Mymichigan Medical Center Midland Midland, MI | $46,454 | $29,072 |
| Nea Baptist Memorial Hospital Jonesboro, AR | $46,487 | $26,118 |
| Athens Limestone Hospital Athens, AL | $46,582 | $24,365 |
| St Luke's Magic Valley Rmc Twin Falls, ID | $49,350 | $28,805 |
| Albany Medical Center Hospital Albany, NY | $49,637 | $31,782 |
| Kansas Surgery & Recovery Center Wichita, KS | $50,861 | $26,435 |
| Penn Highlands Dubois Dubois, PA | $50,977 | $29,616 |
| St Luke's Regional Medical Center Boise, ID | $51,524 | $27,863 |
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.