Level 4 Musculoskeletal Procedures in Vermont
What 6 hospitals in Vermont charged and were paid for level 4 musculoskeletal procedures (APC 5114), from 2024 Medicare claims.
Average charge
$25,332
Hospital list price billed
Average allowed
$3,797
Medicare's payment + patient's share
Medicare paid
$2,383
Average per service
State rank
#1 of 49
1 = lowest average payment
Hospitals in Vermont billed an average of $25,332 for level 4 musculoskeletal procedures, about 6.7 times the average medicare-allowed amount of $3,797. That payment is 43% below 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 $3,797Billed $25,332
About 15¢ was paid for every $1 hospitals in Vermont billed for this service.
Vermont hospitals: level 4 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 | 143 | $25,640 | $3,891 | $2,464 |
| Rutland Regional Medical CenterRutland | 75 | $28,167 | $3,918 | $2,507 |
| Northwestern Medical CenterSt Albans | 57 | $23,796 | $3,044 | $1,633 |
| Central Vermont Medical CenterGraniteville-East Barre | 56 | $21,912 | $2,958 | $1,515 |
| Brattleboro Memorial HospitalBrattleboro | 47 | $25,391 | $5,163 | $3,842 |
| Southwestern Vermont Medical CenterBennington | 28 | $26,040 | $3,909 | $2,451 |
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 | $2,958 |
|---|---|
| Northwestern Medical CenterSt Albans, VT | $3,044 |
| Fletcher Allen Hospital of VermontBurlington, VT | $3,891 |
| Southwestern Vermont Medical CenterBennington, VT | $3,909 |
| Rutland Regional Medical CenterRutland, VT | $3,918 |
Highest
| Brattleboro Memorial HospitalBrattleboro, VT | $5,163 |
|---|---|
| Rutland Regional Medical CenterRutland, VT | $3,918 |
| Southwestern Vermont Medical CenterBennington, VT | $3,909 |
| Fletcher Allen Hospital of VermontBurlington, VT | $3,891 |
| Northwestern Medical CenterSt Albans, VT | $3,044 |
Level 4 Musculoskeletal Procedures in other states
Questions
How much does level 4 musculoskeletal procedures cost in Vermont?
In 2024 Medicare data, level 4 musculoskeletal procedures (APC 5114) at 6 hospitals in Vermont was billed at $25,332 on average, while the average medicare-allowed amount was $3,797, of which Medicare paid $2,383. 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 6.7 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.