Outpatient procedure · APC 8011

Comprehensive Observation Services

In 2024, Medicare and patients paid an average of $2,634 per procedure at 2,753 hospitals. Half of hospitals averaged between $2,362 and $2,697.

Also known as: Observation stay

National figures, 2024

Average payment per case: $2,634
Typical range (middle half of hospitals): $2,362–$2,697
Medicare’s share: $2,09079% of the payment
Average billed charge: $24,060
Hospitals reporting: 2,753815,315 procedures

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2,746 hospitals reported at least 11 Medicare procedures for this in 2024; showing 1–50. Download as CSV

Medicare payments per case for Comprehensive Observation Services by hospital, 2024
Hospital	Cases	Average payment	vs national average	Medicare paid	Billed charge
Central Vermont Medical CenterBarre, VT · CCN 470001	321	$1,132	57% below the national average	$580	$14,233
University Of Vermont - Fletcher Allen Health CareBurlington, VT · CCN 470003	446	$1,180	55% below the national average	$633	$17,273
Riverview Regional Medical CenterGadsden, AL · CCN 010046	13	$1,338	49% below the national average	$877	$30,171
Rutland Regional Medical CenterRutland, VT · CCN 470005	233	$1,375	48% below the national average	$836	$14,999
Marietta Memorial HospitalMarietta, OH · CCN 360147	694	$1,451	45% below the national average	$978	$16,783
MetroHealth SystemCleveland, OH · CCN 360059	351	$1,481	44% below the national average	$1,004	$18,030
Southwestern Vermont Medical CenterBennington, VT · CCN 470012	161	$1,485	44% below the national average	$926	$17,465
Brattleboro Memorial HospitalBrattleboro, VT · CCN 470011 · +$768 outlier payments per case	147	$1,580	40% below the national average	$1,075	$19,902
Essentia Health DuluthDuluth, MN · CCN 240019	15	$1,835	30% below the national average	$1,462	$4,503
Memorial HospitalFremont, OH · CCN 360156	192	$1,958	26% below the national average	$1,483	$18,796
Shelby Baptist Medical CenterAlabaster, AL · CCN 010016	26	$1,973	25% below the national average	$1,500	$30,401
East Liverpool City HospitalEast Liverpool, OH · CCN 360096	11	$1,992	24% below the national average	$1,518	$22,426
Coosa Valley Medical CenterSylacauga, AL · CCN 010164	47	$2,053	22% below the national average	$1,592	$14,641
Princeton Baptist Medical CenterBirmingham, AL · CCN 010103	39	$2,061	22% below the national average	$1,595	$38,159
Saint Francis Bartlett Medical CenterBartlett, TN · CCN 440228	141	$2,091	21% below the national average	$1,619	$41,389
Gadsden Regional Medical CenterGadsden, AL · CCN 010040	96	$2,093	21% below the national average	$1,624	$72,394
Jackson Hospital & Clinic IncMontgomery, AL · CCN 010024	128	$2,100	20% below the national average	$1,635	$14,086
Prattville Baptist HospitalPrattville, AL · CCN 010108	64	$2,101	20% below the national average	$1,629	$10,860
D W McMillan Memorial HospitalBrewton, AL · CCN 010099	108	$2,101	20% below the national average	$1,670	$9,980
Novant Health East Cooper Medical CenterMount Pleasant, SC · CCN 420089	165	$2,124	19% below the national average	$1,637	$29,004
St Vincent's St ClairPell City, AL · CCN 010130	33	$2,128	19% below the national average	$1,662	$13,443
Baptist Medical Center SouthMontgomery, AL · CCN 010023	266	$2,129	19% below the national average	$1,671	$9,931
Stonewall Jackson Memorial Hospital CompanyWeston, WV · CCN 510038	101	$2,132	19% below the national average	$1,675	$15,556
Indian Path Community HospitalKingsport, TN · CCN 440176	13	$2,132	19% below the national average	$1,670	$21,732
Thomasville Regional Medical CenterThomasville, AL · CCN 010174	33	$2,136	19% below the national average	$1,670	$10,925
Mobile Infirmary Medical CenterMobile, AL · CCN 010113	158	$2,138	19% below the national average	$1,676	$10,270
Thomas HospitalFairhope, AL · CCN 010100	130	$2,143	19% below the national average	$1,683	$12,078
Bmh-Golden TriangleColumbus, MS · CCN 250100	121	$2,143	19% below the national average	$1,685	$21,023
Russellville HospitalRussellville, AL · CCN 010158	55	$2,153	18% below the national average	$1,687	$11,808
Piedmont Medical CenterRock Hill, SC · CCN 420002	270	$2,155	18% below the national average	$1,648	$33,947
Clay County HospitalAshland, AL · CCN 010073	34	$2,156	18% below the national average	$1,700	$7,494
Grandview Medical CenterBirmingham, AL · CCN 010104	130	$2,160	18% below the national average	$1,693	$54,031
Walker Baptist Medical CenterJasper, AL · CCN 010089	70	$2,163	18% below the national average	$1,665	$32,852
Christian Hospital NortheastSaint Louis, MO · CCN 260180	25	$2,164	18% below the national average	$1,670	$17,089
Ochsner Medical Center-HancockBay Saint Louis, MS · CCN 250162	48	$2,165	18% below the national average	$1,707	$8,328
University Health System, IncKnoxville, TN · CCN 440015	707	$2,167	18% below the national average	$1,707	$12,561
North Mississippi Health Services - South MarionWinfield, AL · CCN 010086	136	$2,169	18% below the national average	$1,712	$15,578
Dale Medical CenterOzark, AL · CCN 010021	156	$2,169	18% below the national average	$1,711	$13,541
Jack Hughston Memorial HospitalPhenix City, AL · CCN 010168	13	$2,170	18% below the national average	$1,705	$10,461
West Virginia University Hospitals, IncMorgantown, WV · CCN 510001	247	$2,171	18% below the national average	$1,705	$14,362
Baptist Memorial Hospital-Oktibbeha CountyStarkville, MS · CCN 250050	143	$2,173	18% below the national average	$1,730	$8,897
Marshall Medical CentersBoaz, AL · CCN 010005	77	$2,177	17% below the national average	$1,714	$10,296
Bay Park Community HospitalOregon, OH · CCN 360259	191	$2,180	17% below the national average	$1,705	$37,779
Summa Health SystemAkron, OH · CCN 360020	222	$2,180	17% below the national average	$1,704	$28,425
North Alabama Medical CenterFlorence, AL · CCN 010006	224	$2,181	17% below the national average	$1,726	$15,546
USA Health University HospitalMobile, AL · CCN 010087	79	$2,183	17% below the national average	$1,716	$11,031
Parma Community General HospitalParma, OH · CCN 360041	368	$2,184	17% below the national average	$1,712	$15,289
Wheeling Hospital, IncWheeling, WV · CCN 510050	224	$2,185	17% below the national average	$1,719	$12,710
Reynolds Memorial Hospital, IncGlen Dale, WV · CCN 510013	108	$2,187	17% below the national average	$1,732	$11,071
North Baldwin InfirmaryBay Minette, AL · CCN 010129	98	$2,188	17% below the national average	$1,725	$11,621

National trend

Average payment and billed charge per procedure, and how many Medicare procedures were reported each year.

Average payment
Average billed charge

2020: 1,019,189 procedures at 2,860 hospitals · 2021: 965,877 procedures at 2,852 hospitals · 2022: 921,225 procedures at 2,850 hospitals · 2023: 863,129 procedures at 2,798 hospitals · 2024: 815,315 procedures at 2,753 hospitals

View data as a table

National average payment and billed charge for Comprehensive Observation Services
Year of care	Average payment	Average billed charge
2020	$2,173	$19K
2021	$2,303	$20K
2022	$2,330	$22K
2023	$2,422	$23K
2024	$2,634	$24K

By state, 2024

Case-weighted average payment across each state’s reporting hospitals, lowest first.

Show all 50 states

Average payment by state for Comprehensive Observation Services, 2024
State	Hospitals	Cases	Average payment	Typical range
Vermont	5	1,308	$1,285	$1,180–$1,485
Alabama	73	8,112	$2,241	$2,169–$2,264
Mississippi	52	11,311	$2,278	$2,235–$2,347
West Virginia	22	5,181	$2,285	$2,226–$2,367
Louisiana	64	14,412	$2,288	$2,259–$2,300
Tennessee	73	16,493	$2,299	$2,237–$2,337
Ohio	110	31,616	$2,317	$2,300–$2,380
Oklahoma	61	11,406	$2,348	$2,322–$2,440
Arkansas	40	11,142	$2,356	$2,302–$2,439
Kentucky	61	15,821	$2,359	$2,296–$2,442
South Carolina	50	15,082	$2,368	$2,308–$2,382
Kansas	33	7,920	$2,377	$2,321–$2,503
Iowa	31	7,279	$2,385	$2,330–$2,467
Missouri	63	15,191	$2,393	$2,335–$2,465
Michigan	81	23,451	$2,410	$2,364–$2,467
Georgia	92	21,579	$2,422	$2,298–$2,481
North Carolina	78	21,007	$2,426	$2,380–$2,450
Texas	233	58,602	$2,445	$2,375–$2,511
Nebraska	19	3,391	$2,450	$2,431–$2,480
Florida	166	77,597	$2,457	$2,443–$2,471
Maine	17	2,448	$2,457	$2,370–$2,519
Virginia	69	26,889	$2,459	$2,332–$2,524
Indiana	73	18,659	$2,464	$2,412–$2,485
New Mexico	22	4,083	$2,469	$2,369–$2,549
Utah	31	3,560	$2,478	$2,429–$2,452
Wisconsin	61	10,886	$2,497	$2,447–$2,538
Idaho	12	2,397	$2,548	$2,440–$2,614
Pennsylvania	122	33,705	$2,553	$2,415–$2,601
Illinois	113	39,922	$2,573	$2,522–$2,604
North Dakota	6	2,780	$2,590	$2,532–$2,653
Montana	10	3,213	$2,595	$2,543–$2,721
Colorado	48	13,460	$2,608	$2,586–$2,606
Minnesota	45	11,221	$2,627	$2,574–$2,716
New Hampshire	13	5,226	$2,637	$2,593–$2,699
South Dakota	11	2,485	$2,638	$2,559–$2,731
Arizona	54	22,819	$2,686	$2,639–$2,669
Delaware	6	4,912	$2,718	$2,698–$2,727
Wyoming	9	1,733	$2,722	$2,695–$2,745
Rhode Island	9	2,010	$2,752	$2,748–$2,778
District of Columbia	6	1,453	$2,758	$2,739–$2,795
Washington	45	8,931	$2,802	$2,728–$2,893
New Jersey	59	36,741	$2,897	$2,835–$3,029
Nevada	21	7,349	$2,900	$2,857–$2,915
Oregon	32	5,804	$2,901	$2,821–$2,873
Massachusetts	51	32,481	$2,920	$2,905–$2,928
Alaska	6	1,743	$2,936	$2,857–$2,998
New York	115	38,093	$2,983	$2,877–$3,083
Connecticut	26	15,665	$3,045	$3,022–$3,054
Hawaii	12	1,584	$3,127	$3,076–$3,276
California	242	75,162	$3,471	$3,347–$3,602

About these numbers

Average payment is what Medicare paid plus the patient’s deductible and coinsurance (and any other insurer), averaged over the hospital’s Medicare cases. It covers the hospital’s part of the care; doctors bill separately. For outpatient procedures it is Medicare’s allowed amount, which leaves out extra “outlier” payments for unusually costly cases; those are shown under the hospital name where CMS reported any, and included in the CSV. Billed charges are the hospital’s list prices, which few patients pay.

Medicare sets its payments by formula, adjusting for local wages, teaching programs, the share of low-income patients and unusually costly cases. Those adjustments drive most differences between hospitals, so a lower payment doesn’t mean better or worse care, and Medicare patients’ own costs usually vary much less than the totals. Private insurance pays different, usually higher, prices.

Source: CMS Medicare Outpatient Hospitals by Provider and Service (Medicare fee-for-service claims). CMS omits hospitals with fewer than 11 procedures. More in the glossary.