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 2,051–2,100. 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
Trinity HospitalsMinot, ND · CCN 350006	174	$2,683	About average	$2,127	$13,887
Monmouth Medical CenterLong Branch, NJ · CCN 310075 · +$128 outlier payments per case	404	$2,684	About average	$2,093	$25,386
Winona Health ServicesWinona, MN · CCN 240044	111	$2,685	About average	$2,135	$9,604
Ivinson Memorial HospitalLaramie, WY · CCN 530025	71	$2,687	About average	$2,128	$12,581
Gettysburg HospitalGettysburg, PA · CCN 390065	207	$2,687	About average	$2,137	$18,097
Tacoma General Allenmore HospitalTacoma, WA · CCN 500129	154	$2,689	About average	$2,114	$20,456
Saint James HospitalPontiac, IL · CCN 140161	67	$2,692	About average	$2,128	$20,069
St Francis HospitalWilmington, DE · CCN 080003	164	$2,693	About average	$2,140	$14,840
Sheridan Memorial HospitalSheridan, WY · CCN 530006	207	$2,695	About average	$2,146	$10,849
Altru HospitalGrand Forks, ND · CCN 350019	559	$2,697	About average	$2,140	$13,668
Tidalhealth Nanticoke, Inc.Seaford, DE · CCN 080006	201	$2,697	About average	$2,142	$9,759
MultiCare Covington Medical CenterCovington, WA · CCN 500154	23	$2,699	About average	$2,129	$19,406
Portsmouth Regional HospitalPortsmouth, NH · CCN 300029	339	$2,699	About average	$2,144	$34,808
St Anthonys Memorial HospitalEffingham, IL · CCN 140032	460	$2,700	About average	$2,147	$17,221
Centracare- Rice Memorial HospitalWillmar, MN · CCN 240088	98	$2,701	About average	$2,152	$9,078
Christiana HospitalNewark, DE · CCN 080001	1,883	$2,701	About average	$2,141	$13,217
St Mary Medical CenterLanghorne, PA · CCN 390258	772	$2,702	About average	$2,150	$15,270
Valley View Medical CenterFort Mohave, AZ · CCN 030117	69	$2,708	About average	$2,158	$43,754
Palomar Health Downtown CampusEscondido, CA · CCN 050115 · +$264 outlier payments per case	527	$2,709	About average	$2,017	$51,028
Mc Donough District HospitalMacomb, IL · CCN 140089	82	$2,709	About average	$2,158	$17,937
Essentia Health St Marys - Detroit LakesDetroit Lakes, MN · CCN 240101	146	$2,710	About average	$2,159	$12,753
UNC Health Care WayneGoldsboro, NC · CCN 340010	116	$2,712	About average	$2,145	$13,026
Kadlec Regional Medical CenterRichland, WA · CCN 500058 · +$266 outlier payments per case	550	$2,714	About average	$2,153	$21,367
Memorial Hospital Sweetwater CountyRock Springs, WY · CCN 530011	130	$2,715	About average	$2,153	$15,869
Grand Itasca Clinic And HospitalGrand Rapids, MN · CCN 240064	164	$2,716	About average	$2,161	$16,119
Monument Health Spearfish HospitalSpearfish, SD · CCN 430048	69	$2,717	About average	$2,158	$14,162
Multicare Good Samaritan HospitalPuyallup, WA · CCN 500079	216	$2,717	About average	$2,141	$19,490
Multicare Valley HospitalSpokane Valley, WA · CCN 500119	75	$2,718	About average	$2,159	$18,979
CHI St Lukes Health Memorial LivingstonLivingston, TX · CCN 450395	26	$2,718	About average	$2,166	$35,475
Cheyenne Regional Medical CenterCheyenne, WY · CCN 530014	446	$2,720	About average	$2,160	$21,760
Alomere HealthAlexandria, MN · CCN 240030	137	$2,720	About average	$2,165	$17,701
Evergreenhealth Medical CenterKirkland, WA · CCN 500124	224	$2,721	About average	$2,151	$15,031
Sanford Bemidji Medical CenterBemidji, MN · CCN 240100	273	$2,721	About average	$2,166	$15,849
Wellspan Waynesboro HospitalWaynesboro, PA · CCN 390138	242	$2,722	About average	$2,166	$21,149
Bayhealth Hospital, Sussex CampusMilford, DE · CCN 080009	457	$2,722	About average	$2,163	$19,249
Brookings Health SystemBrookings, SD · CCN 430008	90	$2,724	About average	$2,166	$14,204
Valley Medical CenterRenton, WA · CCN 500088	227	$2,724	About average	$2,158	$21,711
Parkland Medical CenterDerry, NH · CCN 300017	144	$2,724	About average	$2,169	$43,905
Virginia Mason Medical CenterSeattle, WA · CCN 500005	131	$2,724	About average	$2,167	$13,329
Kaiser Sunnyside Medical CenterClackamas, OR · CCN 380091	60	$2,726	About average	$2,168	$12,775
Capital Medical CenterOlympia, WA · CCN 500139	97	$2,728	About average	$2,154	$28,716
Deaconess Medical CenterSpokane, WA · CCN 500044	116	$2,728	About average	$2,170	$18,864
Beebe Medical CenterLewes, DE · CCN 080007	1,001	$2,728	About average	$2,169	$19,476
Providence Sacred Heart Medical Center & Childrens HospitalSpokane, WA · CCN 500054	355	$2,729	About average	$2,170	$13,398
Essentia Health St Joseph's Medical CenterBrainerd, MN · CCN 240075	297	$2,729	About average	$2,174	$13,167
Lake Region Healthcare CorporationFergus Falls, MN · CCN 240052	120	$2,729	About average	$2,174	$17,036
Sanford Worthington Medical CenterWorthington, MN · CCN 240022	94	$2,729	About average	$2,174	$14,314
MedStar Georgetown University HospitalWashington, DC · CCN 090004 · +$138 outlier payments per case	313	$2,729	About average	$2,161	$26,007
Prairie Lakes Healthcare System, IncWatertown, SD · CCN 430005	120	$2,730	About average	$2,170	$7,539
Wellspan Chambersburg HospitalChambersburg, PA · CCN 390151	812	$2,731	About average	$2,175	$18,368

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.