facebook tracking Level 3 Musculoskeletal Procedures cost in Hawaii: 11 hospitals compared (APC 5113)

Level 3 Musculoskeletal Procedures in Hawaii

What 11 hospitals in Hawaii charged and were paid for level 3 musculoskeletal procedures (APC 5113), from 2024 Medicare claims.

APC 5113 Outpatient 2024 Medicare data
Average charge $13,819 Hospital list price billed
Average allowed $3,666 Medicare's payment + patient's share
Medicare paid $2,894 Average per service
State rank #48 of 49 1 = lowest average payment

Hospitals in Hawaii billed an average of $13,819 for level 3 musculoskeletal procedures, about 3.8 times the average medicare-allowed amount of $3,666. That payment is 22% 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 $3,666Billed $13,819

About 27¢ was paid for every $1 hospitals in Hawaii billed for this service.

Hawaii hospitals: level 3 musculoskeletal procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
Kuakini Medical CenterHonolulu 56 $6,925 $3,617 $2,860
The Queens Medical CenterHonolulu 55 $21,229 $3,511 $2,747
Wilcox Memorial HospitalLihue 29 $12,690 $3,899 $3,089
Pali Momi Medical CenterAiea 17 $12,327 $3,723 $2,966
Hilo Medical CenterHilo 11 $17,151 $3,987 $3,177
Maui Memorial Medical CenterWailuku – – – –
Castle Medical CenterKailua – – – –
Kaiser Foundation HospitalHonolulu – – – –
Kona Community HospitalKealakekua – – – –
Straub Clinic and HospitalHonolulu – – – –
North Hawaii Community HospitalKamuela – – – –
Advertisement

Lowest and highest allowed amounts in Hawaii

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

Lowest

The Queens Medical CenterHonolulu, HI$3,511
Kuakini Medical CenterHonolulu, HI$3,617
Pali Momi Medical CenterAiea, HI$3,723
Wilcox Memorial HospitalLihue, HI$3,899
Hilo Medical CenterHilo, HI$3,987

Highest

Hilo Medical CenterHilo, HI$3,987
Wilcox Memorial HospitalLihue, HI$3,899
Pali Momi Medical CenterAiea, HI$3,723
Kuakini Medical CenterHonolulu, HI$3,617
The Queens Medical CenterHonolulu, HI$3,511

Level 3 Musculoskeletal Procedures in other states

Questions

How much does level 3 musculoskeletal procedures cost in Hawaii?

In 2024 Medicare data, level 3 musculoskeletal procedures (APC 5113) at 11 hospitals in Hawaii was billed at $13,819 on average, while the average medicare-allowed amount was $3,666, of which Medicare paid $2,894. 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 Hawaii, average charges were 3.8 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.