Outpatient / APC 5491
APC 5491 · 1,174 hospitals · 276,244 services
Level 1 Intraocular Procedures
Hospital outpatient departments billed Medicare for 276,244 services in APC 5491 in 2024. They charged an average of $13,353; Medicare allowed $2,208 — a ratio of 6 to 1 — and paid $1,752 of it, the patient's coinsurance making up most of the rest. Average charges ranged from $2,628 to $97,947 across hospitals.
- 1Average charge $13,353
- 2Medicare allowed $2,208
- 3Reporting hospitals 1,174
- 4Services 276,244
By state
The average charge for this service was highest in Nevada ($51,795) and lowest in Nebraska ($5,786). 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 | 30 | $51,795 | $2,629 |
| Florida | 5,125 | $23,896 | $2,006 |
| District of Columbia | 587 | $23,010 | $2,345 |
| California | 25,956 | $20,986 | $2,981 |
| New Jersey | 2,894 | $20,104 | $2,550 |
| Idaho | 191 | $18,092 | $2,113 |
| Georgia | 5,469 | $18,060 | $2,049 |
| New Mexico | 990 | $17,235 | $1,781 |
| Texas | 14,280 | $16,442 | $2,069 |
| New York | 21,079 | $16,178 | $2,571 |
| Illinois | 18,607 | $14,917 | $2,182 |
| Indiana | 7,155 | $14,609 | $2,094 |
| Pennsylvania | 15,123 | $14,403 | $1,974 |
| South Carolina | 3,845 | $14,119 | $1,771 |
| Louisiana | 7,159 | $14,054 | $1,951 |
| Oklahoma | 4,417 | $13,375 | $2,019 |
| Michigan | 8,420 | $11,973 | $2,050 |
| Virginia | 8,563 | $11,766 | $2,088 |
| New Hampshire | 1,787 | $11,493 | $2,306 |
| Wisconsin | 10,854 | $11,485 | $2,122 |
| Mississippi | 1,738 | $11,181 | $1,739 |
| Arizona | 714 | $11,151 | $2,260 |
| Kentucky | 4,514 | $11,097 | $1,995 |
| Tennessee | 3,113 | $10,656 | $1,924 |
| Missouri | 5,662 | $10,642 | $1,956 |
| Ohio | 13,907 | $10,597 | $1,898 |
| Kansas | 4,428 | $10,535 | $1,923 |
| Maine | 852 | $10,436 | $2,121 |
| Alabama | 4,834 | $10,352 | $1,907 |
| Hawaii | 163 | $10,339 | $2,708 |
| Colorado | 3,766 | $10,331 | $2,229 |
| Washington | 4,602 | $10,318 | $2,422 |
| North Carolina | 17,299 | $10,153 | $2,087 |
| Arkansas | 1,991 | $10,133 | $1,998 |
| Alaska | 544 | $10,066 | $2,159 |
| Connecticut | 4,243 | $9,887 | $2,562 |
| Minnesota | 6,868 | $9,705 | $2,279 |
| Iowa | 5,707 | $9,485 | $2,033 |
| Oregon | 2,485 | $9,194 | $2,456 |
| Montana | 1,121 | $8,811 | $2,156 |
| Delaware | 339 | $8,097 | $2,306 |
| West Virginia | 3,625 | $8,096 | $1,954 |
| Utah | 3,816 | $8,002 | $2,084 |
| South Dakota | 1,899 | $7,991 | $2,280 |
| Wyoming | 828 | $7,471 | $2,156 |
| Rhode Island | 434 | $7,186 | $2,362 |
| Massachusetts | 8,037 | $7,172 | $2,487 |
| Vermont | 1,365 | $7,070 | $1,109 |
| North Dakota | 1,406 | $6,980 | $2,254 |
| Nebraska | 3,413 | $5,786 | $1,975 |
Highest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Good Samaritan Hospital San Jose, CA | $97,947 | $3,282 |
| Adventhealth Lake Wales Lake Wales, FL | $69,525 | $2,125 |
| Regional Medical Center of San Jose San Jose, CA | $60,640 | $3,282 |
| HCA Florida Citrus Hospital Inverness, FL | $57,798 | $2,111 |
| HCA Florida Kendall Hospital Miami, FL | $54,787 | $2,111 |
| HCA Houston Healthcare Kingwood Kingwood, TX | $52,244 | $2,151 |
| Tricities Hospital Hopewell, VA | $52,161 | $1,998 |
| Marinhealth Medical Center Greenbrae, CA | $51,835 | $3,255 |
| Capital Health Medical Center - Hopewell Pennington, NJ | $49,562 | $2,440 |
| HCA Houston Healthcare Northwest Houston, TX | $48,963 | $2,161 |
Lowest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Columbus Community Hospital, Inc Columbus, NE | $2,628 | $1,305 |
| Jones Memorial Hospital Wellsville, NY | $2,685 | $2,646 |
| Oakleaf Surgical Hospital Altoona, WI | $2,833 | $2,093 |
| Billings Clinic Hospital Billings, MT | $3,156 | $2,108 |
| Camc Charleston Surgical Hospital Charleston, WV | $3,255 | $1,927 |
| Geneva General Hospital Geneva, NY | $3,369 | $2,463 |
| Bibb Medical Center Centreville, AL | $3,374 | $1,945 |
| East Alabama Medical Center Opelika, AL | $3,628 | $2,062 |
| Cayuga Medical Center at Ithaca Ithaca, NY | $3,680 | $2,631 |
| Mcleod Regional Medical Center-Pee Dee Florence, SC | $3,725 | $1,962 |
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.