Outpatient / APC 5504
APC 5504 · 98 hospitals · 4,404 services
Level 4 Extraocular, Repair, and Plastic Eye Procedures
Hospital outpatient departments billed Medicare for 4,404 services in APC 5504 in 2024. They charged an average of $26,666; Medicare allowed $3,723 — a ratio of 7.2 to 1 — and paid $2,956 of it, the patient's coinsurance making up most of the rest. Average charges ranged from $9,012 to $88,624 across hospitals.
- 1Average charge $26,666
- 2Medicare allowed $3,723
- 3Reporting hospitals 98
- 4Services 4,404
By state
The average charge for this service was highest in Florida ($41,609) and lowest in Rhode Island ($9,879). 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 |
|---|---|---|---|
| Florida | 214 | $41,609 | $3,461 |
| California | 528 | $40,064 | $4,931 |
| Arizona | 60 | $39,086 | $3,775 |
| Oklahoma | 69 | $35,584 | $3,323 |
| Colorado | 63 | $34,959 | $3,651 |
| Illinois | 136 | $31,983 | $3,655 |
| Tennessee | 100 | $31,404 | $3,250 |
| Ohio | 113 | $29,400 | $3,212 |
| Pennsylvania | 226 | $29,396 | $3,606 |
| Louisiana | 42 | $29,233 | $3,208 |
| Texas | 360 | $28,490 | $3,456 |
| Georgia | 97 | $28,467 | $3,414 |
| South Carolina | 82 | $27,399 | $2,919 |
| New Hampshire | 14 | $25,822 | $3,909 |
| New York | 289 | $25,007 | $4,305 |
| Iowa | 49 | $24,346 | $3,442 |
| Michigan | 209 | $24,282 | $3,214 |
| New Mexico | 18 | $23,509 | $3,422 |
| Washington | 108 | $22,964 | $3,858 |
| Indiana | 88 | $22,775 | $3,444 |
| Kansas | 30 | $22,655 | $3,280 |
| Missouri | 104 | $22,236 | $3,008 |
| Idaho | 15 | $21,723 | $3,329 |
| Wisconsin | 106 | $21,699 | $3,498 |
| Minnesota | 118 | $21,646 | $3,836 |
| Virginia | 72 | $21,527 | $3,472 |
| New Jersey | 50 | $21,366 | $4,257 |
| Maine | 27 | $21,163 | $3,082 |
| North Carolina | 183 | $20,777 | $3,455 |
| Arkansas | 41 | $20,164 | $3,247 |
| Kentucky | 62 | $19,025 | $3,342 |
| Connecticut | 25 | $18,386 | $4,203 |
| West Virginia | 30 | $18,025 | $3,176 |
| South Dakota | 15 | $17,892 | $3,625 |
| Mississippi | 17 | $17,702 | $2,885 |
| Oregon | 107 | $16,273 | $4,058 |
| Nebraska | 80 | $13,855 | $3,448 |
| Utah | 100 | $12,843 | $3,408 |
| Massachusetts | 181 | $12,422 | $4,116 |
| Alabama | 91 | $12,090 | $3,099 |
| North Dakota | 22 | $11,784 | $3,514 |
| Montana | 12 | $10,551 | $3,406 |
| Rhode Island | 14 | $9,879 | $3,924 |
Highest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Stanford Health Care Stanford, CA | $88,624 | $5,445 |
| Tampa General Hospital Tampa, FL | $84,941 | $3,502 |
| Memorial Hermann Texas Medical Center Houston, TX | $70,276 | $3,585 |
| Loma Linda University Medical Center Loma Linda, CA | $63,738 | $4,754 |
| HCA Florida South Tampa Hospital Tampa, FL | $62,435 | $3,502 |
| UCSF Medical Center San Francisco, CA | $57,632 | $5,444 |
| Geisinger Medical Center Danville, PA | $53,742 | $3,453 |
| Northwestern Memorial Hospital Chicago, IL | $53,410 | $3,630 |
| James Cancer Hospital & Solove Research Institute Columbus, OH | $51,807 | $3,457 |
| UPMC Presbyterian Shadyside Pittsburgh, PA | $50,077 | $3,453 |
Lowest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Novant Health Presbyterian Medical Center Charlotte, NC | $9,012 | $3,105 |
| Rhode Island Hospital Providence, RI | $9,879 | $3,924 |
| Inova Fairfax Hospital Falls Church, VA | $10,153 | $3,626 |
| Intermountain Medical Center Murray, UT | $10,388 | $3,464 |
| University of Utah Hospital and Clinics Salt Lake City, UT | $10,598 | $3,351 |
| Tufts Medical Center Boston, MA | $11,049 | $3,958 |
| UAB Callahan Eye Hospital Authority Birmingham, AL | $11,554 | $3,095 |
| Suny Health Science Center at Brooklyn University Brooklyn, NY | $11,638 | $4,400 |
| Sanford Fargo, ND | $11,660 | $3,497 |
| Albany Medical Center Hospital Albany, NY | $12,160 | $4,099 |
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.