facebook tracking Level 4 Musculoskeletal Procedures cost in West Virginia: 23 hospitals compared (APC 5114)

Level 4 Musculoskeletal Procedures in West Virginia

What 23 hospitals in West Virginia charged and were paid for level 4 musculoskeletal procedures (APC 5114), from 2024 Medicare claims.

APC 5114 Outpatient 2024 Medicare data
Average charge $36,472 Hospital list price billed
Average allowed $6,000 Medicare's payment + patient's share
Medicare paid $4,736 Average per service
State rank #7 of 49 1 = lowest average payment

Hospitals in West Virginia billed an average of $36,472 for level 4 musculoskeletal procedures, about 6.1 times the average medicare-allowed amount of $6,000. That payment is 11% 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 $6,000Billed $36,472

About 16¢ was paid for every $1 hospitals in West Virginia billed for this service.

West Virginia hospitals: level 4 musculoskeletal procedures

Every West 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
West Virginia University HospitalsMorgantown 132 $37,402 $5,691 $4,483
United Hospital CenterBridgeport 120 $31,094 $6,641 $5,263
Berkeley Medical CenterMartinsburg 95 $30,935 $6,356 $5,019
Thomas Memorial HospitalSouth Charleston 75 $34,316 $5,616 $4,381
Camden Clark Memorial HospitalParkersburg 69 $29,691 $5,872 $4,640
Cabell-Huntington Hospital INCHuntington 67 $38,881 $5,822 $4,580
Charleston Area Medical CenterCharleston 66 $54,628 $5,992 $4,752
Wheeling HospitalWheeling 66 $40,303 $5,985 $4,769
St Mary's Medical CenterHuntington 63 $28,609 $5,940 $4,699
Princeton Community HospitalPrinceton 57 $36,619 $6,045 $4,741
Raleigh General HospitalBeckley 54 $50,517 $5,975 $4,742
Camc Charleston Surgical HospitalCharleston 35 $14,609 $5,650 $4,418
Davis Memorial HospitalElkins 27 $33,640 $5,956 $4,670
Saint Francis HospitalCharleston 26 $34,776 $5,879 $4,646
Greenbrier Valley Medical CenterRonceverte 24 $51,419 $6,335 $5,000
Reynolds Memorial HospitalGlen Dale 24 $32,066 $5,457 $4,269
Mon Health Medical CenterMorgantown 19 $60,732 $6,059 $4,828
Logan Regional Medical CenterLogan 12 $37,347 $6,260 $4,988
Beckley Arh HospitalBeckley 11 $32,408 $6,065 $4,832
Rivers HealthPoint Pleasant – – – –
Weirton Medical CenterWeirton – – – –
Stonewall Jackson Mem HospWeston – – – –
Wetzel County HospitalNew Martinsville – – – –
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Lowest and highest allowed amounts in West 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

Reynolds Memorial HospitalGlen Dale, WV$5,457
Thomas Memorial HospitalSouth Charleston, WV$5,616
Camc Charleston Surgical HospitalCharleston, WV$5,650
West Virginia University HospitalsMorgantown, WV$5,691
Cabell-Huntington Hospital INCHuntington, WV$5,822

Highest

United Hospital CenterBridgeport, WV$6,641
Berkeley Medical CenterMartinsburg, WV$6,356
Greenbrier Valley Medical CenterRonceverte, WV$6,335
Logan Regional Medical CenterLogan, WV$6,260
Beckley Arh HospitalBeckley, WV$6,065

Level 4 Musculoskeletal Procedures in other states

Questions

How much does level 4 musculoskeletal procedures cost in West Virginia?

In 2024 Medicare data, level 4 musculoskeletal procedures (APC 5114) at 23 hospitals in West Virginia was billed at $36,472 on average, while the average medicare-allowed amount was $6,000, of which Medicare paid $4,736. 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 West Virginia, 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.