Level 3 Musculoskeletal Procedures in Wisconsin
What 63 hospitals in Wisconsin charged and were paid for level 3 musculoskeletal procedures (APC 5113), from 2024 Medicare claims.
Average charge
$17,878
Hospital list price billed
Average allowed
$2,921
Medicare's payment + patient's share
Medicare paid
$2,316
Average per service
State rank
#28 of 49
1 = lowest average payment
Hospitals in Wisconsin billed an average of $17,878 for level 3 musculoskeletal procedures, about 6.1 times the average medicare-allowed amount of $2,921. That payment is 2% 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 $2,921Billed $17,878
About 16¢ was paid for every $1 hospitals in Wisconsin billed for this service.
Wisconsin hospitals: level 3 musculoskeletal procedures
Every Wisconsin hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| University of Wi Hospitals & Clinics AuthorityMadison | 163 | $18,079 | $2,994 | $2,373 |
| Oakleaf Surgical HospitalEau Claire | 131 | $14,707 | $2,909 | $2,316 |
| Gundersen Luth Med CtrLa Crosse | 119 | $17,800 | $2,798 | $2,225 |
| Aurora Baycare Med CtrGreen Bay | 110 | $16,569 | $2,872 | $2,280 |
| Fort HealthcareFort Atkinson | 106 | $18,924 | $2,927 | $2,327 |
| Orthopaedic Hsptl of WiGlendale | 90 | $15,951 | $2,949 | $2,346 |
| Luther Hospital Mayo Health SystemEau Claire | 86 | $11,541 | $2,985 | $2,361 |
| Bellin Memorial HsptlGreen Bay | 84 | $19,361 | $2,773 | $2,192 |
| Mercy Hlth Sys CorpJanesville | 83 | $15,723 | $2,786 | $2,204 |
| Aurora Medical CenterGrafton | 78 | $27,882 | $2,944 | $2,341 |
| Appleton Med CtrAppleton | 74 | $11,628 | $2,729 | $2,135 |
| Meriter HsptlMadison | 67 | $16,145 | $3,022 | $2,406 |
| Mayo Clinic Health System-Franciscan Medical CenterLa Crosse | 66 | $11,577 | $3,013 | $2,393 |
| Sauk Prairie Mem HsptlPrairie du Sac | 62 | $13,171 | $2,914 | $2,309 |
| St Marys Hsptl Med CtrGreen Bay | 59 | $20,359 | $2,872 | $2,280 |
| Aurora St Lukes Medical CenterMilwaukee | 59 | $27,475 | $2,988 | $2,365 |
| Marshfield Medical CenterMarshfield | 58 | $12,377 | $3,019 | $2,383 |
| Midwest Orthopedic Specialty Hospital, LLCFranklin | 56 | $24,563 | $2,823 | $2,214 |
| Community Mem HsptlMenomonee Falls | 54 | $20,938 | $2,949 | $2,349 |
| Marshfield Medical Center - Eau ClaireEau Claire | 54 | $10,489 | $2,866 | $2,271 |
| Aurora Med Ctr Manitowoc CtyTwo Rivers | 49 | $19,424 | $2,735 | $2,170 |
| Aurora Memorial Hsptl BurlingtonBurlington | 49 | $22,694 | $2,995 | $2,373 |
| Froedtert Mem Lutheran HsptlMilwaukee | 46 | $35,822 | $2,940 | $2,321 |
| Columbia St Marys Hsptl Milw (Col & Milw Campus)Milwaukee | 45 | $22,447 | $3,046 | $2,425 |
| Aspirus Wausau HospitalWausau | 44 | $13,997 | $2,844 | $2,255 |
| Beloit Mem HsptlBeloit | 42 | $21,324 | $3,148 | $2,507 |
| St Agnes HsptlFond du Lac | 41 | $13,337 | $3,038 | $2,396 |
| Aurora Med Ctr KenoshaKenosha | 40 | $29,881 | $2,923 | $2,303 |
| Froedtert SouthKenosha | 38 | $16,117 | $3,044 | $2,425 |
| Aurora Sheboygan Mem Med CtrSheboygan | 36 | $16,058 | $2,946 | $2,342 |
| Aurora Med Ctr OshkoshOshkosh | 36 | $16,284 | $2,914 | $2,322 |
| St Elizabeth HsptlAppleton | 35 | $12,181 | $2,914 | $2,322 |
| Waukesha Memorial HospitalWaukesha | 31 | $21,893 | $2,949 | $2,343 |
| Monroe ClinicMonroe | 29 | $18,817 | $2,773 | $2,152 |
| Holy Family Memorial INCManitowoc | 28 | $17,599 | $2,911 | $2,319 |
| Mile Bluff Medical Center, INCMauston | 26 | $12,408 | $3,007 | $2,376 |
| UW Hlth Partners - Watertown Regional Medical CtrWatertown | 26 | $17,249 | $2,949 | $2,348 |
| Aurora Medical CenterSummit | 26 | $14,299 | $2,951 | $2,344 |
| SSM Health St Mary's Hospital - JanesvilleJanesville | 26 | $12,293 | $2,952 | $2,333 |
| St Clare Hsptl Hlth SvcsBaraboo | 25 | $11,762 | $2,857 | $2,257 |
| Beaver Dam Com HsptlBeaver Dam | 22 | $15,556 | $2,951 | $2,351 |
| Ascension SE Wisconsin HospitalMilwaukee | 21 | $20,425 | $2,949 | $2,349 |
| Aurora West Allis Medical CenterWest Allis | 21 | $22,750 | $2,921 | $2,313 |
| Marshfield Medical Center - Rice LakeRice Lake | 18 | $10,300 | $3,102 | $2,465 |
| Divine Savior HlthcarePortage | 17 | $16,595 | $2,891 | $2,266 |
| St Josephs Com Hsptl West BendWest Bend | 17 | $24,184 | $2,811 | $2,210 |
| Wheaton Franciscan Healthcare- All SaintsRacine | 17 | $27,239 | $3,046 | $2,427 |
| Bay Area Med CtrMarinette | 17 | $19,252 | $2,970 | $2,337 |
| Howard Young Med CtrWoodruff | 16 | $11,079 | $3,102 | $2,471 |
| Aurora Med Center-Washington CountyHartford | 15 | $31,382 | $2,795 | $2,195 |
| Aspirus Rhinelander HospitalRhinelander | 14 | $12,558 | $3,102 | $2,471 |
| St Nicholas HospitalSheboygan | 14 | $16,984 | $2,946 | $2,348 |
| Oconomowoc Mem HsptlOconomowoc | 13 | $24,618 | $2,768 | $2,169 |
| Aurora Lakeland Med CtrElkhorn | 13 | $19,674 | $3,044 | $2,425 |
| Ministry St Michaels Hospital of Stevens PointStevens Point | – | – | – | – |
| Sacred Heart HospitalEau Claire | – | – | – | – |
| Aspirus Riverview Hospital & ClinicsWisconsin Rapids | – | – | – | – |
| Thedacare Regional Med Ctr - NeenahNeenah | – | – | – | – |
| St Vincent HsptlGreen Bay | – | – | – | – |
| Wheaton Franciscan Healthcare- St FrancisMilwaukee | – | – | – | – |
| St Mary's HospitalMadison | – | – | – | – |
| St Clare's Hospital of Weston INCWeston | – | – | – | – |
| Marshfield Medical Center - MinocquaMinocqua | – | – | – | – |
Lowest and highest allowed amounts in Wisconsin
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
| Appleton Med CtrAppleton, WI | $2,729 |
|---|---|
| Aurora Med Ctr Manitowoc CtyTwo Rivers, WI | $2,735 |
| Oconomowoc Mem HsptlOconomowoc, WI | $2,768 |
| Bellin Memorial HsptlGreen Bay, WI | $2,773 |
| Monroe ClinicMonroe, WI | $2,773 |
Highest
| Beloit Mem HsptlBeloit, WI | $3,148 |
|---|---|
| Marshfield Medical Center - Rice LakeRice Lake, WI | $3,102 |
| Aspirus Rhinelander HospitalRhinelander, WI | $3,102 |
| Howard Young Med CtrWoodruff, WI | $3,102 |
| Columbia St Marys Hsptl Milw (Col & Milw Campus)Milwaukee, WI | $3,046 |
Level 3 Musculoskeletal Procedures in other states
Questions
How much does level 3 musculoskeletal procedures cost in Wisconsin?
In 2024 Medicare data, level 3 musculoskeletal procedures (APC 5113) at 63 hospitals in Wisconsin was billed at $17,878 on average, while the average medicare-allowed amount was $2,921, of which Medicare paid $2,316. 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 Wisconsin, average charges were 6.1 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.