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

Level 3 Musculoskeletal Procedures in Vermont

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

APC 5113 Outpatient 2024 Medicare data
Average charge $11,847 Hospital list price billed
Average allowed $1,583 Medicare's payment + patient's share
Medicare paid $942 Average per service
State rank #1 of 49 1 = lowest average payment

Hospitals in Vermont billed an average of $11,847 for level 3 musculoskeletal procedures, about 7.5 times the average medicare-allowed amount of $1,583. That payment is 47% below 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 $1,583Billed $11,847

About 13¢ was paid for every $1 hospitals in Vermont billed for this service.

Vermont hospitals: level 3 musculoskeletal procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
Fletcher Allen Hospital of VermontBurlington 149 $10,858 $1,509 $866
Central Vermont Medical CenterGraniteville-East Barre 72 $9,706 $1,187 $533
Rutland Regional Medical CenterRutland 65 $14,536 $1,834 $1,189
Brattleboro Memorial HospitalBrattleboro 47 $12,133 $2,087 $1,491
Northwestern Medical CenterSt Albans 41 $12,200 $1,249 $610
Southwestern Vermont Medical CenterBennington 39 $14,382 $1,920 $1,260
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Lowest and highest allowed amounts in Vermont

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

Central Vermont Medical CenterGraniteville-East Barre, VT$1,187
Northwestern Medical CenterSt Albans, VT$1,249
Fletcher Allen Hospital of VermontBurlington, VT$1,509
Rutland Regional Medical CenterRutland, VT$1,834
Southwestern Vermont Medical CenterBennington, VT$1,920

Highest

Level 3 Musculoskeletal Procedures in other states

Questions

How much does level 3 musculoskeletal procedures cost in Vermont?

In 2024 Medicare data, level 3 musculoskeletal procedures (APC 5113) at 6 hospitals in Vermont was billed at $11,847 on average, while the average medicare-allowed amount was $1,583, of which Medicare paid $942. 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 Vermont, average charges were 7.5 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.