Level 3 Musculoskeletal Procedures
What 2,760 hospitals in the U.S. charged and were paid for level 3 musculoskeletal procedures (APC 5113), from 2024 Medicare claims.
Average charge
$23,966
Hospital list price billed
Average allowed
$2,995
Medicare's payment + patient's share
Medicare paid
$2,373
Average per service
Volume
104,003
Medicare services
Hospitals in the U.S. billed an average of $23,966 for level 3 musculoskeletal procedures, about 8.0 times the average medicare-allowed amount of $2,995.
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.
Lowest and highest allowed amounts
Among hospitals with at least 20 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Central Vermont Medical CenterGraniteville-East Barre, VT | $1,187 |
|---|---|
| Northwestern Medical CenterSt Albans, VT | $1,249 |
| University Medical Center of El PasoEl Paso, TX | $1,335 |
| Southwest General Health CenterMiddleburg Heights, OH | $1,419 |
| Toppenish Community HospitalToppenish, WA | $1,490 |
| Fletcher Allen Hospital of VermontBurlington, VT | $1,509 |
| Athens-Limestone HospitalAthens, AL | $1,599 |
| Memorial Hospital at GulfportGulfport, MS | $1,618 |
| Oklahoma Heart Hospital SouthOklahoma City, OK | $1,627 |
| Gettysburg HospitalGettysburg, PA | $1,664 |
Highest
| Northbay Medical CenterFairfield, CA | $4,657 |
|---|---|
| St Mary's Medical CenterSan Francisco, CA | $4,627 |
| Peninsula Medical CenterBurlingame, CA | $4,572 |
| San Francisco General HospitalSan Francisco, CA | $4,564 |
| Santa Clara Valley Medical CenterSan Jose, CA | $4,558 |
| Sequoia HospitalRedwood City, CA | $4,558 |
| Community Hospital of the Monterey PeninsulaMonterey, CA | $4,558 |
| El Camino HospitalMountain View, CA | $4,558 |
| John Muir Medical Center - Concord CampusConcord, CA | $4,507 |
| San Ramon Regional Medical CtrSan Ramon, CA | $4,507 |
Level 3 Musculoskeletal Procedures cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg allowed | Range |
|---|---|---|---|---|
| Alabama | 59 | $32,437 | $2,552 | $1,599 – $2,884 |
| Alaska | 6 | $21,379 | $3,415 | $3,246 – $3,578 |
| Arizona | 52 | $29,396 | $3,136 | $2,624 – $3,504 |
| Arkansas | 37 | $15,247 | $2,751 | $2,541 – $2,973 |
| California | 249 | $36,474 | $4,064 | $2,363 – $4,657 |
| Colorado | 51 | $29,511 | $3,070 | $2,862 – $3,300 |
| Connecticut | 25 | $18,372 | $3,562 | $2,877 – $3,727 |
| Delaware | 6 | $15,629 | $3,203 | $3,169 – $3,248 |
| Florida | 162 | $42,808 | $2,883 | $1,700 – $3,140 |
| Georgia | 87 | $28,659 | $2,723 | $1,878 – $3,043 |
| Hawaii | 11 | $13,819 | $3,666 | $3,511 – $3,987 |
| Idaho | 15 | $15,036 | $2,879 | $2,369 – $3,120 |
| Illinois | 105 | $23,478 | $2,967 | $2,049 – $3,204 |
| Indiana | 76 | $24,062 | $2,859 | $2,522 – $3,131 |
| Iowa | 31 | $17,114 | $2,782 | $2,476 – $3,138 |
| Kansas | 42 | $15,690 | $2,754 | $2,273 – $3,042 |
| Kentucky | 54 | $21,154 | $2,727 | $2,382 – $2,984 |
| Louisiana | 66 | $23,661 | $2,668 | $2,157 – $2,805 |
| Maine | 17 | $16,204 | $2,895 | $2,641 – $3,135 |
| Massachusetts | 53 | $13,137 | $3,414 | $2,899 – $3,604 |
| Michigan | 86 | $17,492 | $2,779 | $1,894 – $3,096 |
| Minnesota | 46 | $13,180 | $2,975 | $2,749 – $3,263 |
| Mississippi | 35 | $20,970 | $2,519 | $1,618 – $2,903 |
| Missouri | 61 | $18,408 | $2,773 | $1,936 – $3,066 |
| Montana | 10 | $12,991 | $3,003 | $2,884 – $3,250 |
| Nebraska | 24 | $14,561 | $2,813 | $1,835 – $2,992 |
| Nevada | 19 | $41,935 | $3,395 | $3,126 – $3,930 |
| New Hampshire | 13 | $18,827 | $3,114 | $3,018 – $3,222 |
| New Jersey | 60 | $23,692 | $3,401 | $2,331 – $3,683 |
| New Mexico | 21 | $28,946 | $2,895 | $2,627 – $3,118 |
| New York | 124 | $20,959 | $3,442 | $1,824 – $3,748 |
| North Carolina | 78 | $20,018 | $2,846 | $2,349 – $3,059 |
| North Dakota | 6 | $12,558 | $3,059 | $3,008 – $3,168 |
| Ohio | 117 | $20,422 | $2,715 | $1,419 – $2,950 |
| Oklahoma | 55 | $21,497 | $2,735 | $1,627 – $3,006 |
| Oregon | 30 | $18,071 | $3,424 | $2,909 – $4,093 |
| Pennsylvania | 128 | $24,977 | $2,901 | $1,664 – $3,412 |
| Rhode Island | 9 | $8,390 | $3,249 | $3,182 – $3,285 |
| South Carolina | 49 | $26,186 | $2,688 | $2,024 – $2,991 |
| South Dakota | 14 | $16,044 | $3,054 | $2,955 – $3,250 |
| Tennessee | 70 | $22,365 | $2,620 | $2,007 – $2,969 |
| Texas | 247 | $29,887 | $2,828 | $1,335 – $3,214 |
| Utah | 33 | $14,685 | $2,882 | $2,418 – $3,106 |
| Vermont | 6 | $11,847 | $1,583 | $1,187 – $2,087 |
| Virginia | 66 | $28,580 | $2,856 | $2,480 – $3,141 |
| Washington | 45 | $22,300 | $3,260 | $1,490 – $3,479 |
| West Virginia | 23 | $17,828 | $2,683 | $2,395 – $3,033 |
| Wisconsin | 63 | $17,878 | $2,921 | $2,729 – $3,148 |
| Wyoming | 10 | $18,765 | $3,183 | $2,976 – $3,250 |
Hospitals that treat the most Medicare patients for this
| Hospital | Services | Avg charge | Avg allowed |
|---|---|---|---|
| NYU Hospitals CenterNew York, NY | 587 | $37,928 | $3,583 |
| Massachusetts General HospitalBoston, MA | 406 | $27,092 | $3,430 |
| Stanford HospitalPalo Alto, CA | 393 | $66,869 | $4,370 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | 392 | $15,723 | $2,749 |
| Texas Spine and Joint HospitalTyler, TX | 383 | $22,114 | $2,762 |
| Lehigh Valley HospitalAllentown, PA | 379 | $20,135 | $3,086 |
| Hospital for Special SurgeryNew York, NY | 342 | $29,976 | $3,518 |
| Sioux Falls Surgical Hospital LLPSioux Falls, SD | 335 | $21,492 | $3,014 |
| Roper HospitalCharleston, SC | 329 | $16,887 | $2,726 |
| Community HospitalOklahoma City, OK | 300 | $27,971 | $2,744 |
| Norton Healthcare PavilionLouisville, KY | 298 | $20,223 | $2,746 |
| Crystal Clinic Orthopaedic CenterAkron, OH | 297 | $15,910 | $2,735 |
| Newton-Wellesley HospitalNewton Lower Falls, MA | 291 | $12,899 | $3,457 |
| Sanford Medical Center FargoFargo, ND | 291 | $11,443 | $3,035 |
| Avera McKennan Hospital & University Health CenterSioux Falls, SD | 290 | $18,432 | $3,018 |
Questions
How much does level 3 musculoskeletal procedures cost in the U.S.?
In 2024 Medicare data, level 3 musculoskeletal procedures (APC 5113) at 2,760 hospitals in the U.S. was billed at $23,966 on average, while the average medicare-allowed amount was $2,995, of which Medicare paid $2,373. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for level 3 musculoskeletal procedures?
Among states with at least three hospitals reporting, the average medicare-allowed amount was highest in California ($4,064), Hawaii ($3,666), Connecticut ($3,562) and lowest in Vermont ($1,583), Mississippi ($2,519), Alabama ($2,552).
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 the U.S., average charges were 8.0 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.