Level 4 Musculoskeletal Procedures
What 2,738 hospitals in the U.S. charged and were paid for level 4 musculoskeletal procedures (APC 5114), from 2024 Medicare claims.
Average charge
$46,846
Hospital list price billed
Average allowed
$6,708
Medicare's payment + patient's share
Medicare paid
$5,339
Average per service
Volume
166,476
Medicare services
Hospitals in the U.S. billed an average of $46,846 for level 4 musculoskeletal procedures, about 7.0 times the average medicare-allowed amount of $6,708.
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 $6,708Billed $46,846
About 14¢ was paid for every $1 hospitals in the U.S. billed for this service.
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 | $2,958 |
|---|---|
| Northwestern Medical CenterSt Albans, VT | $3,044 |
| Toppenish Community HospitalToppenish, WA | $3,088 |
| University Medical Center of El PasoEl Paso, TX | $3,212 |
| St Mary Mercy HospitalLivonia, MI | $3,560 |
| Baptist Memorial Hospital HuntingdonHuntingdon, TN | $3,585 |
| SSM St Joseph Health CenterSt Charles, MO | $3,858 |
| Fletcher Allen Hospital of VermontBurlington, VT | $3,891 |
| Southwestern Vermont Medical CenterBennington, VT | $3,909 |
| Rutland Regional Medical CenterRutland, VT | $3,918 |
Highest
| St Mary's Medical CenterSan Francisco, CA | $10,217 |
|---|---|
| Northbay Medical CenterFairfield, CA | $10,092 |
| California Pacific Medical Ctr-Davies Campus HospSan Francisco, CA | $10,074 |
| Santa Clara Valley Medical CenterSan Jose, CA | $10,066 |
| Stanford Health Care Tri-ValleyPleasanton, CA | $10,066 |
| Good Samaritan HospitalSan Jose, CA | $10,066 |
| Washington HospitalFremont, CA | $10,066 |
| Salinas Valley Memorial HospitalSalinas, CA | $10,066 |
| Santa Rosa Memorial HospitalSanta Rosa, CA | $10,011 |
| El Camino HospitalMountain View, CA | $9,998 |
Level 4 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 | 55 | $54,840 | $5,780 | $4,073 – $6,410 |
| Alaska | 6 | $57,857 | $7,642 | $7,259 – $7,908 |
| Arizona | 52 | $57,539 | $7,012 | $6,676 – $7,744 |
| Arkansas | 32 | $27,016 | $6,128 | $5,856 – $6,530 |
| California | 245 | $69,795 | $9,047 | $6,302 – $10,284 |
| Colorado | 49 | $59,465 | $6,822 | $6,367 – $7,294 |
| Connecticut | 26 | $37,950 | $7,916 | $7,514 – $8,320 |
| Delaware | 7 | $32,133 | $7,128 | $7,038 – $7,178 |
| Florida | 161 | $74,028 | $6,397 | $5,185 – $6,940 |
| Georgia | 86 | $55,004 | $6,231 | $5,295 – $6,986 |
| Hawaii | 11 | $31,855 | $8,172 | $7,720 – $8,809 |
| Idaho | 15 | $32,787 | $6,476 | $5,737 – $6,925 |
| Illinois | 104 | $44,915 | $6,652 | $6,099 – $7,081 |
| Indiana | 76 | $46,937 | $6,361 | $5,684 – $6,921 |
| Iowa | 31 | $33,489 | $6,231 | $5,814 – $6,869 |
| Kansas | 43 | $32,569 | $6,178 | $5,795 – $6,767 |
| Kentucky | 53 | $44,622 | $6,103 | $5,605 – $6,594 |
| Louisiana | 65 | $42,930 | $5,934 | $5,761 – $6,194 |
| Maine | 17 | $31,132 | $6,469 | $5,863 – $6,823 |
| Massachusetts | 54 | $25,168 | $7,605 | $6,366 – $8,228 |
| Michigan | 88 | $32,188 | $6,197 | $3,560 – $6,842 |
| Minnesota | 46 | $27,225 | $6,909 | $6,475 – $7,256 |
| Mississippi | 38 | $39,713 | $5,823 | $4,199 – $6,368 |
| Missouri | 61 | $34,851 | $6,179 | $3,858 – $6,819 |
| Montana | 10 | $28,785 | $6,754 | $6,566 – $7,183 |
| Nebraska | 24 | $29,688 | $6,401 | $6,134 – $6,944 |
| Nevada | 19 | $67,810 | $7,592 | $7,209 – $8,683 |
| New Hampshire | 14 | $41,037 | $6,863 | $6,550 – $7,308 |
| New Jersey | 57 | $44,520 | $7,592 | $6,154 – $8,140 |
| New Mexico | 22 | $49,487 | $6,455 | $5,883 – $7,185 |
| New York | 126 | $40,866 | $7,713 | $5,151 – $8,140 |
| North Carolina | 79 | $38,813 | $6,354 | $5,702 – $6,999 |
| North Dakota | 6 | $23,712 | $6,773 | $6,689 – $7,052 |
| Ohio | 116 | $40,609 | $6,094 | $4,188 – $6,638 |
| Oklahoma | 55 | $40,831 | $6,079 | $5,654 – $6,601 |
| Oregon | 31 | $33,561 | $7,605 | $6,638 – $9,298 |
| Pennsylvania | 125 | $47,692 | $6,566 | $3,187 – $7,540 |
| Rhode Island | 10 | $15,779 | $7,123 | $6,719 – $7,260 |
| South Carolina | 49 | $51,302 | $5,959 | $4,713 – $6,676 |
| South Dakota | 14 | $32,545 | $6,722 | $6,577 – $7,184 |
| Tennessee | 65 | $40,557 | $5,874 | $3,585 – $6,562 |
| Texas | 245 | $58,862 | $6,317 | $3,212 – $6,938 |
| Utah | 33 | $33,485 | $6,374 | $5,974 – $6,864 |
| Vermont | 6 | $25,332 | $3,797 | $2,958 – $5,163 |
| Virginia | 64 | $53,283 | $6,335 | $5,625 – $6,998 |
| Washington | 46 | $45,301 | $7,247 | $3,088 – $7,955 |
| West Virginia | 23 | $36,472 | $6,000 | $5,457 – $6,641 |
| Wisconsin | 63 | $32,827 | $6,482 | $6,012 – $6,958 |
| Wyoming | 10 | $35,529 | $6,970 | $6,495 – $7,183 |
Hospitals that treat the most Medicare patients for this
| Hospital | Services | Avg charge | Avg allowed |
|---|---|---|---|
| NYU Hospitals CenterNew York, NY | 860 | $84,600 | $8,004 |
| Massachusetts General HospitalBoston, MA | 650 | $43,344 | $7,608 |
| Hospital for Special SurgeryNew York, NY | 642 | $47,547 | $7,916 |
| Lehigh Valley HospitalAllentown, PA | 622 | $50,993 | $6,860 |
| Baptist Medical CenterJacksonville, FL | 609 | $45,864 | $6,403 |
| Stanford HospitalPalo Alto, CA | 575 | $102,226 | $9,975 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | 558 | $31,967 | $7,178 |
| New York-Presbyterian HospitalNew York, NY | 556 | $39,359 | $8,133 |
| Methodist Hospital,TheHouston, TX | 507 | $66,993 | $6,533 |
| Evanston HospitalEvanston, IL | 477 | $33,367 | $6,605 |
| Huntsville HospitalHuntsville, AL | 469 | $34,593 | $5,849 |
| North Central Surgical Center LLPDallas, TX | 464 | $31,789 | $6,344 |
| Cedars-Sinai Medical CenterLos Angeles, CA | 452 | $131,998 | $8,704 |
| Arkansas Surgical HospitalNorth Little Rock, AR | 442 | $17,347 | $6,010 |
| New Hanover Regional Medical CenterWilmington, NC | 442 | $34,717 | $6,627 |
Questions
How much does level 4 musculoskeletal procedures cost in the U.S.?
In 2024 Medicare data, level 4 musculoskeletal procedures (APC 5114) at 2,738 hospitals in the U.S. was billed at $46,846 on average, while the average medicare-allowed amount was $6,708, of which Medicare paid $5,339. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for level 4 musculoskeletal procedures?
Among states with at least three hospitals reporting, the average medicare-allowed amount was highest in California ($9,047), Hawaii ($8,172), Connecticut ($7,916) and lowest in Vermont ($3,797), Alabama ($5,780), Mississippi ($5,823).
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 7.0 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.