Level 4 Musculoskeletal Procedures in Hawaii
What 11 hospitals in Hawaii charged and were paid for level 4 musculoskeletal procedures (APC 5114), from 2024 Medicare claims.
Average charge
$31,855
Hospital list price billed
Average allowed
$8,172
Medicare's payment + patient's share
Medicare paid
$6,539
Average per service
State rank
#48 of 49
1 = lowest average payment
Hospitals in Hawaii billed an average of $31,855 for level 4 musculoskeletal procedures, about 3.9 times the average medicare-allowed amount of $8,172. That payment is 22% above the U.S. average 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 $8,172Billed $31,855
About 26¢ was paid for every $1 hospitals in Hawaii billed for this service.
Hawaii hospitals: level 4 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 |
|---|---|---|---|---|
| The Queens Medical CenterHonolulu | 107 | $46,633 | $7,993 | $6,358 |
| Kuakini Medical CenterHonolulu | 83 | $13,924 | $8,227 | $6,595 |
| Wilcox Memorial HospitalLihue | 55 | $27,256 | $8,418 | $6,786 |
| Pali Momi Medical CenterAiea | 36 | $25,261 | $7,861 | $6,229 |
| Castle Medical CenterKailua | 34 | $30,187 | $8,035 | $6,396 |
| Maui Memorial Medical CenterWailuku | 27 | $34,296 | $8,562 | $6,930 |
| Straub Clinic and HospitalHonolulu | 26 | $31,400 | $7,720 | $6,088 |
| Hilo Medical CenterHilo | 19 | $30,104 | $8,809 | $7,177 |
| North Hawaii Community HospitalKamuela | 19 | $44,459 | $8,054 | $6,419 |
| Kona Community HospitalKealakekua | 13 | $46,764 | $8,809 | $7,177 |
| Kaiser Foundation HospitalHonolulu | – | – | – | – |
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
| Straub Clinic and HospitalHonolulu, HI | $7,720 |
|---|---|
| Pali Momi Medical CenterAiea, HI | $7,861 |
| The Queens Medical CenterHonolulu, HI | $7,993 |
| Castle Medical CenterKailua, HI | $8,035 |
| North Hawaii Community HospitalKamuela, HI | $8,054 |
Highest
| Hilo Medical CenterHilo, HI | $8,809 |
|---|---|
| Kona Community HospitalKealakekua, HI | $8,809 |
| Maui Memorial Medical CenterWailuku, HI | $8,562 |
| Wilcox Memorial HospitalLihue, HI | $8,418 |
| Kuakini Medical CenterHonolulu, HI | $8,227 |
Level 4 Musculoskeletal Procedures in other states
Questions
How much does level 4 musculoskeletal procedures cost in Hawaii?
In 2024 Medicare data, level 4 musculoskeletal procedures (APC 5114) at 11 hospitals in Hawaii was billed at $31,855 on average, while the average medicare-allowed amount was $8,172, of which Medicare paid $6,539. 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 3.9 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.