facebook tracking Level 2 Musculoskeletal Procedures cost in Delaware: 6 hospitals compared (APC 5112)

Level 2 Musculoskeletal Procedures in Delaware

What 6 hospitals in Delaware charged and were paid for level 2 musculoskeletal procedures (APC 5112), from 2024 Medicare claims.

APC 5112 Outpatient 2024 Medicare data
Average charge $6,361 Hospital list price billed
Average allowed $1,610 Medicare's payment + patient's share
Medicare paid $1,280 Average per service
State rank #38 of 49 1 = lowest average payment

Hospitals in Delaware billed an average of $6,361 for level 2 musculoskeletal procedures, about 4.0 times the average medicare-allowed amount of $1,610. That payment is 7% above the U.S. average of $1,511.

These are averages for patients with original (fee-for-service) Medicare. Private insurance pays different, negotiated prices, and what you owe depends on your plan's deductible and coinsurance. Use these figures to compare hospitals, not as a quote.

Paid $1,610Billed $6,361

About 25¢ was paid for every $1 hospitals in Delaware billed for this service.

Delaware hospitals: level 2 musculoskeletal procedures

Every Delaware hospital that billed Medicare for this service at least 11 times. Click a column to sort.

Hospital Services Avg charge Avg allowed Medicare paid
Bayhealth - Kent General HospitalDover 104 $5,808 $1,617 $1,286
Beebe Medical CenterLewes 84 $7,912 $1,613 $1,284
Christiana Care Health Services, INC.Newark 59 $6,537 $1,592 $1,261
Bayhealth Hospital, Sussex CampusMilford 56 $5,471 $1,613 $1,280
Nanticoke Memorial HospitalSeaford 32 $5,314 $1,613 $1,281
St Francis HospitalWilmington – – – –
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Lowest and highest allowed amounts in Delaware

Among hospitals with at least 11 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.

Level 2 Musculoskeletal Procedures in other states

Questions

How much does level 2 musculoskeletal procedures cost in Delaware?

In 2024 Medicare data, level 2 musculoskeletal procedures (APC 5112) at 6 hospitals in Delaware was billed at $6,361 on average, while the average medicare-allowed amount was $1,610, of which Medicare paid $1,280. Your own cost depends on your insurance, deductible and the hospital.

Why are hospital charges so much higher than payments?

Charges are a hospital's list prices. Medicare pays fixed rates set in advance, and private insurers negotiate their own discounts, so almost nobody pays the full charge. For this service in Delaware, average charges were 4.0 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.

Source: CMS, Medicare Outpatient Hospitals by Provider and Service, 2024. The allowed amount is Medicare's payment plus the patient's coinsurance. CMS omits hospitals with fewer than 11 services for privacy. About the data.