facebook tracking Level 3 Musculoskeletal Procedures cost in Delaware: 6 hospitals compared (APC 5113)

Level 3 Musculoskeletal Procedures in Delaware

What 6 hospitals in Delaware charged and were paid for level 3 musculoskeletal procedures (APC 5113), from 2024 Medicare claims.

APC 5113 Outpatient 2024 Medicare data
Average charge $15,629 Hospital list price billed
Average allowed $3,203 Medicare's payment + patient's share
Medicare paid $2,544 Average per service
State rank #38 of 49 1 = lowest average payment

Hospitals in Delaware billed an average of $15,629 for level 3 musculoskeletal procedures, about 4.9 times the average medicare-allowed amount of $3,203. That payment is 7% above the U.S. average 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.

Paid $3,203Billed $15,629

About 20¢ was paid for every $1 hospitals in Delaware billed for this service.

Delaware hospitals: level 3 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
Beebe Medical CenterLewes 140 $18,413 $3,211 $2,548
Christiana Care Health Services, INC.Newark 105 $12,762 $3,169 $2,509
Nanticoke Memorial HospitalSeaford 66 $9,213 $3,248 $2,583
Bayhealth - Kent General HospitalDover 49 $17,378 $3,189 $2,541
St Francis HospitalWilmington 36 $21,190 $3,185 $2,537
Bayhealth Hospital, Sussex CampusMilford 19 $18,194 $3,248 $2,587
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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.

Highest

Level 3 Musculoskeletal Procedures in other states

Questions

How much does level 3 musculoskeletal procedures cost in Delaware?

In 2024 Medicare data, level 3 musculoskeletal procedures (APC 5113) at 6 hospitals in Delaware was billed at $15,629 on average, while the average medicare-allowed amount was $3,203, of which Medicare paid $2,544. 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 4.9 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.