Outpatient / APC 5493
APC 5493 · 308 hospitals · 12,169 services
Level 3 Intraocular Procedures
Hospital outpatient departments billed Medicare for 12,169 services in APC 5493 in 2024. They charged an average of $28,480; Medicare allowed $5,015 — a ratio of 5.7 to 1 — and paid $3,983 of it, the patient's coinsurance making up most of the rest. Average charges ranged from $5,806 to $155,924 across hospitals.
- 1Average charge $28,480
- 2Medicare allowed $5,015
- 3Reporting hospitals 308
- 4Services 12,169
By state
The average charge for this service was highest in Nevada ($80,720) and lowest in Wyoming ($8,939). 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 | 64 | $80,720 | $5,624 |
| Florida | 325 | $48,302 | $4,531 |
| California | 1,234 | $45,367 | $6,769 |
| Idaho | 31 | $42,954 | $4,600 |
| New Mexico | 61 | $37,019 | $4,329 |
| New Jersey | 265 | $33,969 | $5,656 |
| Texas | 614 | $33,252 | $4,605 |
| Illinois | 417 | $32,994 | $4,919 |
| Oklahoma | 255 | $32,767 | $4,485 |
| New York | 732 | $32,321 | $5,794 |
| South Carolina | 176 | $31,576 | $3,977 |
| Louisiana | 417 | $31,344 | $4,373 |
| Tennessee | 180 | $31,143 | $4,456 |
| Georgia | 304 | $30,926 | $4,638 |
| District of Columbia | 14 | $29,424 | $5,348 |
| Arizona | 74 | $29,405 | $4,900 |
| Indiana | 236 | $28,473 | $4,718 |
| Michigan | 297 | $28,160 | $4,653 |
| Colorado | 118 | $27,225 | $4,943 |
| Pennsylvania | 596 | $25,962 | $4,658 |
| Oregon | 121 | $25,931 | $5,470 |
| Mississippi | 101 | $25,749 | $4,148 |
| Washington | 177 | $25,554 | $5,343 |
| Kentucky | 92 | $25,002 | $4,517 |
| Utah | 231 | $24,518 | $4,588 |
| Virginia | 365 | $24,313 | $4,592 |
| Arkansas | 101 | $24,102 | $4,370 |
| Ohio | 304 | $23,861 | $4,055 |
| Kansas | 228 | $23,282 | $4,326 |
| North Carolina | 755 | $23,230 | $4,705 |
| Wisconsin | 359 | $22,880 | $4,775 |
| Missouri | 430 | $22,384 | $4,392 |
| Iowa | 226 | $22,211 | $4,567 |
| Minnesota | 394 | $20,878 | $5,108 |
| Alabama | 180 | $20,520 | $4,338 |
| Hawaii | 18 | $19,092 | $4,947 |
| New Hampshire | 98 | $18,455 | $5,322 |
| Vermont | 43 | $17,797 | $2,757 |
| West Virginia | 125 | $17,381 | $4,377 |
| South Dakota | 55 | $17,255 | $4,990 |
| Connecticut | 312 | $17,154 | $5,726 |
| Montana | 86 | $16,074 | $4,889 |
| North Dakota | 103 | $14,677 | $5,184 |
| Massachusetts | 578 | $14,421 | $5,605 |
| Delaware | 55 | $14,413 | $5,244 |
| Nebraska | 177 | $13,846 | $4,384 |
| Rhode Island | 21 | $12,757 | $5,304 |
| Wyoming | 11 | $8,939 | $4,805 |
Highest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Good Samaritan Hospital San Jose, CA | $155,924 | $7,197 |
| HCA Florida Northside Hospital Saint Petersburg, FL | $130,329 | $4,734 |
| Sunrise Hospital and Medical Center Las Vegas, NV | $126,135 | $5,141 |
| Tampa General Hospital Tampa, FL | $98,862 | $4,734 |
| Lutheran Downtown Hospital Fort Wayne, IN | $98,163 | $4,746 |
| Englewood Hospital Englewood, NJ | $93,005 | $5,947 |
| Scripps Memorial Hospital La Jolla La Jolla, CA | $85,697 | $6,227 |
| Merit Health Biloxi Biloxi, MS | $82,771 | $4,268 |
| Wesley Medical Center Wichita, KS | $79,376 | $4,462 |
| Stanford Health Care Stanford, CA | $78,746 | $7,360 |
Lowest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Camc Charleston Surgical Hospital Charleston, WV | $5,806 | $4,431 |
| Summit Medical Center Casper, WY | $8,939 | $4,805 |
| Lahey Hospital & Medical Center, Burlington Burlington, MA | $9,077 | $5,613 |
| Russell Medical Center Alexander City, AL | $9,192 | $4,322 |
| Columbus Community Hospital, Inc Columbus, NE | $9,367 | $3,111 |
| Billings Clinic Hospital Billings, MT | $9,571 | $4,818 |
| Straith Hospital for Special Surgery Southfield, MI | $9,822 | $4,270 |
| Day Kimball Hospital Putnam, CT | $9,866 | $5,830 |
| Bronson Methodist Hospital Kalamazoo, MI | $11,238 | $4,571 |
| Lincoln Surgical Hospital Lincoln, NE | $11,341 | $4,667 |
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.