Level 4 Musculoskeletal Procedures in Virginia
What 64 hospitals in Virginia charged and were paid for level 4 musculoskeletal procedures (APC 5114), from 2024 Medicare claims.
Average charge
$53,283
Hospital list price billed
Average allowed
$6,335
Medicare's payment + patient's share
Medicare paid
$5,029
Average per service
State rank
#18 of 49
1 = lowest average payment
Hospitals in Virginia billed an average of $53,283 for level 4 musculoskeletal procedures, about 8.4 times the average medicare-allowed amount of $6,335. That payment is 6% 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 $6,335Billed $53,283
About 12¢ was paid for every $1 hospitals in Virginia billed for this service.
Virginia hospitals: level 4 musculoskeletal procedures
Every Virginia 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 Virginia Medical CenterCharlottesville | 409 | $36,088 | $6,215 | $4,936 |
| Carilion Medical CenterRoanoke | 227 | $51,376 | $6,072 | $4,818 |
| Henrico Doctors' HospitalRichmond | 207 | $158,012 | $6,164 | $4,900 |
| Inova Fairfax HospitalFalls Church | 199 | $28,341 | $6,466 | $5,126 |
| Sentara Leigh HospitalNorfolk | 172 | $34,507 | $6,196 | $4,930 |
| Virginia Hospital Center - ArlingtonArlington | 157 | $32,150 | $6,709 | $5,343 |
| Bon Secours - St Marys Hospital of RichmondRichmond | 155 | $52,079 | $6,401 | $5,064 |
| Winchester Medical Center INCWinchester | 150 | $20,800 | $6,960 | $5,530 |
| Cjw Medical CenterRichmond | 149 | $150,979 | $6,159 | $4,907 |
| Sentara Rmh Medical CenterHarrisonburg | 146 | $30,930 | $6,998 | $5,567 |
| Sentara Bayside HospitalVirginia Beach | 145 | $36,844 | $6,088 | $4,822 |
| Augusta HealthFishersville | 139 | $46,116 | $6,875 | $5,470 |
| Centra Health - Lynchburg Gen HospitalLynchburg | 129 | $41,413 | $6,555 | $5,215 |
| Bon Secours - Memorial Regional MedicalMechanicsville | 119 | $49,721 | $6,438 | $5,102 |
| Medical College of Virginia HospitalsRichmond | 103 | $57,173 | $5,899 | $4,674 |
| Riverside Regional Medical CenterNewport News | 103 | $23,767 | $6,160 | $4,908 |
| Reston Hospital CenterReston | 103 | $63,608 | $6,690 | $5,311 |
| Bon Secours - St Francis Medical CenterMidlothian | 101 | $62,240 | $6,219 | $4,955 |
| Mary Immaculate HospitalNewport News | 85 | $51,273 | $5,986 | $4,734 |
| Carilion New River Vly Med CtrChristiansburg | 85 | $68,055 | $6,159 | $4,907 |
| Inova Alexandria HospitalAlexandria | 80 | $30,100 | $6,642 | $5,278 |
| Martha Jefferson HospitalCharlottesville | 80 | $29,852 | $6,220 | $4,956 |
| Chesapeake General HospitalChesapeake | 73 | $39,410 | $6,089 | $4,824 |
| Mary Washington Hospital, INCFredericksburg | 68 | $22,339 | $6,551 | $5,188 |
| Bon Secours - Maryview Medical CenterPortsmouth | 63 | $65,671 | $6,081 | $4,827 |
| Montgomery Regional HospitalBlacksburg | 62 | $118,770 | $6,167 | $4,909 |
| Riverside Doctors' Hospital of WilliamsburgWilliamsburg | 62 | $26,359 | $5,922 | $4,670 |
| Sentara Virginia Beach General HospitalVirginia Beach | 54 | $36,342 | $6,133 | $4,868 |
| Sentara Careplex HospitalHampton | 54 | $30,269 | $6,133 | $4,868 |
| Sentara Norfolk General HospitalNorfolk | 49 | $35,784 | $6,225 | $4,960 |
| Inova Fair Oaks HospitalFairfax | 48 | $29,470 | $6,597 | $5,234 |
| Sentara Obici HospitalSuffolk | 46 | $34,246 | $5,625 | $4,437 |
| Inova Loudoun HospitalLeesburg | 43 | $30,044 | $6,460 | $5,096 |
| Culpeper Regional HospitalCulpeper | 40 | $39,132 | $6,468 | $5,105 |
| The Fauquier Hospital, INCWarrenton | 38 | $57,289 | $6,427 | $5,064 |
| John Randolph Medical CenterHopewell | 36 | $212,110 | $6,225 | $4,960 |
| Inova Mount Vernon HospitalAlexandria | 36 | $28,957 | $6,708 | $5,345 |
| Riverside Walter Reed HospitalGloucester | 35 | $28,199 | $5,879 | $4,624 |
| Sentara Williamsburg Regional Medical CenterWilliamsburg | 32 | $36,481 | $6,006 | $4,754 |
| Lewisgale Medical CenterSalem | 30 | $142,589 | $5,999 | $4,741 |
| Stafford Hospital CenterStafford | 30 | $31,640 | $6,530 | $5,167 |
| Stonesprings Hospital CenterDulles | 30 | $61,694 | $6,530 | $5,167 |
| Johnston Memorial HospitalAbingdon | 28 | $62,068 | $5,849 | $4,591 |
| Southside Regional Medical CenterPetersburg | 25 | $94,103 | $6,026 | $4,761 |
| Sentara Northern Virginia Medical CenterWoodbridge | 25 | $40,833 | $6,281 | $4,914 |
| Danville Regional Medical CenterDanville | 21 | $81,812 | $6,357 | $5,065 |
| Riverside Tappahannock HospitalTappahannock | 21 | $21,117 | $6,414 | $5,059 |
| UVA Health Haymarket Medical CenterHaymarket | 21 | $36,774 | $6,765 | $5,390 |
| Warren Memorial HospitalFront Royal | 20 | $19,229 | $6,174 | $4,810 |
| Prince William HospitalManassas | 20 | $25,799 | $6,765 | $5,390 |
| Spotsylvania Regional Medical CenterFredericksburg | 19 | $46,504 | $6,708 | $5,345 |
| Smyth County Community HospitalMarion | 15 | $71,613 | $6,159 | $4,907 |
| Pulaski Community HospitalPulaski | 13 | $148,582 | $5,782 | $4,516 |
| Riverside Shore Memorial HospitalNassawadox | 12 | $23,789 | $6,596 | $5,255 |
| Community Memorial Healthcenter, INCSouth Hill | 11 | $45,440 | $6,667 | $5,312 |
| Alleghany Regional HospitalJackson River | 11 | $67,227 | $6,596 | $5,255 |
| Halifax Regional HospitalSouth Boston | – | – | – | – |
| Clinch Valley Medical CenterRichlands | – | – | – | – |
| Carilion Franklin Memorial HospitalRocky Mount | – | – | – | – |
| Southampton Memorial HospitalFranklin | – | – | – | – |
| Bon Secours - Richmond Community HospitalRichmond | – | – | – | – |
| Wythe County Community HospitalWytheville | – | – | – | – |
| Wellmont Lonesome Pine HospitalBig Stone Gap | – | – | – | – |
| Twin County Regional HospitalGalax | – | – | – | – |
Lowest and highest allowed amounts in Virginia
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
| Sentara Obici HospitalSuffolk, VA | $5,625 |
|---|---|
| Pulaski Community HospitalPulaski, VA | $5,782 |
| Johnston Memorial HospitalAbingdon, VA | $5,849 |
| Riverside Walter Reed HospitalGloucester, VA | $5,879 |
| Medical College of Virginia HospitalsRichmond, VA | $5,899 |
Highest
| Sentara Rmh Medical CenterHarrisonburg, VA | $6,998 |
|---|---|
| Winchester Medical Center INCWinchester, VA | $6,960 |
| Augusta HealthFishersville, VA | $6,875 |
| Prince William HospitalManassas, VA | $6,765 |
| UVA Health Haymarket Medical CenterHaymarket, VA | $6,765 |
Level 4 Musculoskeletal Procedures in other states
Questions
How much does level 4 musculoskeletal procedures cost in Virginia?
In 2024 Medicare data, level 4 musculoskeletal procedures (APC 5114) at 64 hospitals in Virginia was billed at $53,283 on average, while the average medicare-allowed amount was $6,335, of which Medicare paid $5,029. 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 Virginia, average charges were 8.4 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.