Outpatient / APC 5492
APC 5492 · 527 hospitals · 48,265 services
Level 2 Intraocular Procedures
Hospital outpatient departments billed Medicare for 48,265 services in APC 5492 in 2024. They charged an average of $25,823; Medicare allowed $3,925 — a ratio of 6.6 to 1 — and paid $3,117 of it, the patient's coinsurance making up most of the rest. Average charges ranged from $4,467 to $130,313 across hospitals.
- 1Average charge $25,823
- 2Medicare allowed $3,925
- 3Reporting hospitals 527
- 4Services 48,265
By state
The average charge for this service was highest in Nevada ($59,480) and lowest in Wyoming ($8,707). 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 | 461 | $59,480 | $4,593 |
| California | 5,813 | $40,214 | $5,193 |
| Florida | 1,759 | $36,194 | $3,549 |
| District of Columbia | 64 | $36,096 | $4,007 |
| New Hampshire | 104 | $35,695 | $4,065 |
| New Mexico | 267 | $35,585 | $3,361 |
| Kansas | 569 | $34,648 | $3,187 |
| Arizona | 131 | $33,141 | $3,950 |
| Indiana | 692 | $31,907 | $3,674 |
| Idaho | 166 | $31,627 | $3,632 |
| Mississippi | 413 | $30,472 | $3,344 |
| Georgia | 717 | $29,775 | $3,602 |
| South Carolina | 813 | $29,753 | $3,360 |
| Tennessee | 726 | $29,504 | $3,421 |
| Louisiana | 847 | $29,286 | $3,381 |
| Texas | 2,080 | $27,661 | $3,601 |
| Illinois | 2,244 | $27,497 | $3,833 |
| New York | 3,328 | $27,383 | $4,487 |
| Iowa | 667 | $24,804 | $3,575 |
| Alaska | 32 | $24,733 | $4,225 |
| Pennsylvania | 2,698 | $24,551 | $3,742 |
| New Jersey | 1,190 | $24,302 | $4,331 |
| Washington | 879 | $22,286 | $4,155 |
| Oklahoma | 1,079 | $22,274 | $3,455 |
| Wisconsin | 1,570 | $21,027 | $3,737 |
| Minnesota | 831 | $20,792 | $4,037 |
| Colorado | 845 | $20,712 | $3,851 |
| Michigan | 1,645 | $20,548 | $3,557 |
| North Carolina | 2,795 | $19,914 | $3,632 |
| Alabama | 1,047 | $19,889 | $3,354 |
| Virginia | 1,421 | $19,841 | $3,705 |
| Kentucky | 466 | $19,726 | $3,421 |
| Ohio | 1,727 | $19,534 | $3,172 |
| Missouri | 1,566 | $19,404 | $3,364 |
| Oregon | 863 | $19,381 | $4,216 |
| Delaware | 92 | $18,816 | $3,940 |
| Utah | 728 | $18,742 | $3,599 |
| Arkansas | 837 | $18,694 | $3,439 |
| West Virginia | 470 | $18,525 | $3,396 |
| Hawaii | 123 | $17,176 | $4,502 |
| Nebraska | 421 | $16,570 | $3,648 |
| Connecticut | 306 | $15,589 | $4,456 |
| Montana | 172 | $14,587 | $3,922 |
| Maine | 34 | $14,474 | $3,653 |
| North Dakota | 304 | $13,750 | $3,865 |
| South Dakota | 184 | $12,911 | $3,866 |
| Vermont | 93 | $12,883 | $1,933 |
| Massachusetts | 1,910 | $11,718 | $4,343 |
| Rhode Island | 63 | $9,908 | $4,126 |
| Wyoming | 13 | $8,707 | $3,817 |
Highest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Good Samaritan Hospital San Jose, CA | $130,313 | $5,708 |
| UCLA West Valley Medical Center West Hills, CA | $100,315 | $4,999 |
| HCA Florida Northside Hospital Saint Petersburg, FL | $92,902 | $3,683 |
| Sunrise Hospital and Medical Center Las Vegas, NV | $83,552 | $4,297 |
| HCA Houston Healthcare Kingwood Kingwood, TX | $82,490 | $3,770 |
| Stanford Health Care Stanford, CA | $80,501 | $5,725 |
| Tampa General Hospital Tampa, FL | $80,246 | $3,645 |
| NYU Langone Hospitals New York, NY | $79,838 | $4,546 |
| Merit Health Biloxi Biloxi, MS | $77,499 | $3,320 |
| Summerlin Hospital Medical Center Las Vegas, NV | $75,470 | $4,320 |
Lowest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Geneva General Hospital Geneva, NY | $4,467 | $4,311 |
| Clarion Hospital Clarion, PA | $4,733 | $3,890 |
| Penn Highlands Connellsville Connellsville, PA | $5,365 | $3,632 |
| Billings Clinic Hospital Billings, MT | $5,837 | $3,783 |
| Providence Hospital Mobile, AL | $6,456 | $3,287 |
| Mymichigan Medical Center West Branch West Branch, MI | $6,478 | $3,794 |
| St Lukes Hospital Duluth, MN | $7,184 | $3,857 |
| South Shore Hospital South Weymouth, MA | $7,198 | $4,367 |
| Loyola Gottlieb Memorial Hospital Melrose Park, IL | $7,470 | $3,954 |
| Straith Hospital for Special Surgery Southfield, MI | $7,735 | $3,551 |
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.