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 2,701–2,746. 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
Kaiser Foundation Hospital - SacramentoSacramento, CA · CCN 050425	179	$3,759	43% above the national average	$2,991	$35,165
Highland HospitalOakland, CA · CCN 050320 · +$1,754 outlier payments per case	315	$3,765	43% above the national average	$2,997	$48,035
San Ramon Regional Medical CenterSan Ramon, CA · CCN 050689 · +$742 outlier payments per case	185	$3,774	43% above the national average	$3,000	$104,503
Eden Medical CenterCastro Valley, CA · CCN 050488 · +$180 outlier payments per case	413	$3,779	44% above the national average	$3,006	$39,556
Kaiser Foundation Hospital - FremontFremont, CA · CCN 050512	53	$3,780	44% above the national average	$3,011	$39,169
Kaiser Foundation Hospital-Santa ClaraSanta Clara, CA · CCN 050071	50	$3,780	44% above the national average	$3,004	$41,254
St Rose HospitalHayward, CA · CCN 050002	180	$3,784	44% above the national average	$3,012	$28,878
Novato Community HospitalNovato, CA · CCN 050131	106	$3,794	44% above the national average	$3,017	$33,742
John Muir Medical Center - Concord CampusConcord, CA · CCN 050496 · +$269 outlier payments per case	399	$3,796	44% above the national average	$3,021	$67,008
Alameda HospitalAlameda, CA · CCN 050211 · +$589 outlier payments per case	107	$3,801	44% above the national average	$3,028	$49,877
Alta Bates Summit Medical CenterOakland, CA · CCN 050043	254	$3,801	44% above the national average	$3,027	$32,967
Alta Bates Summit Medical Center - Alta Bates CampBerkeley, CA · CCN 050305	133	$3,801	44% above the national average	$3,027	$35,539
Sutter Delta Medical CenterAntioch, CA · CCN 050523	504	$3,805	44% above the national average	$3,030	$38,083
John Muir Medical Center - Walnut Creek CampusWalnut Creek, CA · CCN 050180 · +$307 outlier payments per case	598	$3,806	45% above the national average	$3,031	$63,665
Sutter Medical Center, SacramentoSacramento, CA · CCN 050108 · +$169 outlier payments per case	551	$3,806	45% above the national average	$3,026	$32,772
UCSF Medical CenterSan Francisco, CA · CCN 050454 · +$821 outlier payments per case	624	$3,817	45% above the national average	$3,033	$43,574
Salinas Valley Health Medical CenterSalinas, CA · CCN 050334	518	$3,817	45% above the national average	$3,035	$42,017
MarinHealth Medical CenterGreenbrae, CA · CCN 050360 · +$77 outlier payments per case	725	$3,819	45% above the national average	$3,041	$63,472
Good Samaritan HospitalSan Jose, CA · CCN 050380	257	$3,819	45% above the national average	$3,034	$96,714
El Camino HealthMountain View, CA · CCN 050308 · +$352 outlier payments per case	671	$3,823	45% above the national average	$3,036	$57,738
Kaiser Foundation Hospital - Oakland/RichmondOakland, CA · CCN 050075	220	$3,823	45% above the national average	$3,039	$36,124
Kaiser Foundation Hospital And Rehab CenterVallejo, CA · CCN 050073 · +$302 outlier payments per case	166	$3,827	45% above the national average	$3,036	$45,682
Providence Santa Rosa Memorial HospitalSanta Rosa, CA · CCN 050174 · +$379 outlier payments per case	661	$3,829	45% above the national average	$3,050	$49,475
Providence Queen Of The Valley Medical CenterNapa, CA · CCN 050009 · +$139 outlier payments per case	421	$3,832	46% above the national average	$3,053	$52,413
Sequoia HospitalRedwood City, CA · CCN 050197 · +$405 outlier payments per case	131	$3,832	46% above the national average	$3,047	$49,237
Kaiser Foundation Hospital - VacavilleVacaville, CA · CCN 050767	118	$3,836	46% above the national average	$3,046	$50,642
Kaiser Foundation Hospital - Redwood CityRedwood City, CA · CCN 050541	29	$3,837	46% above the national average	$3,050	$32,390
Kaiser Foundation Hospital - South San FranciscoSouth San Francisco, CA · CCN 050070	20	$3,837	46% above the national average	$3,038	$35,233
UCSF Health Saint Francis HospitalSan Francisco, CA · CCN 050152	53	$3,839	46% above the national average	$3,058	$42,280
Stanford Health CareStanford, CA · CCN 050441 · +$1,051 outlier payments per case	2,217	$3,839	46% above the national average	$3,056	$76,792
Washington HospitalFremont, CA · CCN 050195 · +$69 outlier payments per case	793	$3,843	46% above the national average	$3,059	$37,465
Stanford Health Care Tri-ValleyPleasanton, CA · CCN 050283 · +$127 outlier payments per case	488	$3,848	46% above the national average	$3,064	$54,565
Community Hospital Of The Monterey PeninsulaMonterey, CA · CCN 050145	1,017	$3,852	46% above the national average	$3,068	$22,597
Santa Clara Valley Medical CenterSan Jose, CA · CCN 050038 · +$1,299 outlier payments per case	594	$3,854	46% above the national average	$3,071	$29,327
Regional Medical Center Of San JoseSan Jose, CA · CCN 050125	79	$3,855	46% above the national average	$3,058	$102,210
Peninsula Medical CenterBurlingame, CA · CCN 050007	244	$3,875	47% above the national average	$3,078	$29,515
California Pacific Medical Center-Davies Campus HospitalSan Francisco, CA · CCN 050008	80	$3,876	47% above the national average	$3,078	$27,973
Zuckerberg San Francisco General Hospital & Trauma CenterSan Francisco, CA · CCN 050228 · +$936 outlier payments per case	290	$3,886	48% above the national average	$3,095	$41,931
Sutter Solano Medical CenterVallejo, CA · CCN 050101	144	$3,895	48% above the national average	$3,084	$38,314
San Mateo Medical CenterSan Mateo, CA · CCN 050113	13	$3,913	49% above the national average	$3,117	$10,350
California Pacific Medical Center- Van Ness CampusSan Francisco, CA · CCN 050047	220	$3,913	49% above the national average	$3,117	$29,918
UCSF Health St. Mary's HospitalSan Francisco, CA · CCN 050457	93	$3,913	49% above the national average	$3,117	$33,680
California Pacific Medical Center - Mission BernalSan Francisco, CA · CCN 050055	44	$3,913	49% above the national average	$3,115	$29,887
Chinese HospitalSan Francisco, CA · CCN 050407	50	$3,913	49% above the national average	$3,114	$22,418
AHMC Seton Medical CenterDaly City, CA · CCN 050289	105	$3,913	49% above the national average	$3,107	$45,167
NorthBay Medical CenterFairfield, CA · CCN 050367 · +$324 outlier payments per case	661	$3,929	49% above the national average	$3,127	$67,950

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.