Level 4 Musculoskeletal Procedures in Wisconsin
What 63 hospitals in Wisconsin charged and were paid for level 4 musculoskeletal procedures (APC 5114), from 2024 Medicare claims.
Average charge
$32,827
Hospital list price billed
Average allowed
$6,482
Medicare's payment + patient's share
Medicare paid
$5,146
Average per service
State rank
#27 of 49
1 = lowest average payment
Hospitals in Wisconsin billed an average of $32,827 for level 4 musculoskeletal procedures, about 5.1 times the average medicare-allowed amount of $6,482. That payment is 3% 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 $6,482Billed $32,827
About 20¢ was paid for every $1 hospitals in Wisconsin billed for this service.
Wisconsin hospitals: level 4 musculoskeletal procedures
Every Wisconsin 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 Wi Hospitals & Clinics AuthorityMadison | 288 | $36,814 | $6,653 | $5,292 |
| Luther Hospital Mayo Health SystemEau Claire | 187 | $21,235 | $6,657 | $5,291 |
| Gundersen Luth Med CtrLa Crosse | 165 | $33,589 | $6,307 | $5,012 |
| Aurora Baycare Med CtrGreen Bay | 156 | $28,429 | $6,375 | $5,066 |
| St Mary's HospitalMadison | 153 | $27,566 | $6,600 | $5,251 |
| Oakleaf Surgical HospitalEau Claire | 145 | $27,583 | $6,359 | $5,051 |
| Bellin Memorial HsptlGreen Bay | 141 | $39,277 | $6,338 | $5,041 |
| Orthopaedic Hsptl of WiGlendale | 112 | $28,556 | $6,287 | $4,958 |
| Appleton Med CtrAppleton | 108 | $28,092 | $6,210 | $4,899 |
| Aspirus Wausau HospitalWausau | 93 | $31,473 | $6,401 | $5,100 |
| Community Mem HsptlMenomonee Falls | 89 | $35,941 | $6,342 | $5,018 |
| Aurora St Lukes Medical CenterMilwaukee | 89 | $46,407 | $6,506 | $5,133 |
| Aurora Med Ctr KenoshaKenosha | 83 | $40,607 | $6,722 | $5,353 |
| Fort HealthcareFort Atkinson | 81 | $31,089 | $6,325 | $5,000 |
| Midwest Orthopedic Specialty Hospital, LLCFranklin | 80 | $36,232 | $6,517 | $5,189 |
| Aurora Medical CenterGrafton | 79 | $41,025 | $6,448 | $5,121 |
| Sauk Prairie Mem HsptlPrairie du Sac | 76 | $19,018 | $6,457 | $5,129 |
| Meriter HsptlMadison | 75 | $37,556 | $6,607 | $5,247 |
| Marshfield Medical CenterMarshfield | 73 | $30,574 | $6,706 | $5,310 |
| Marshfield Medical Center - Eau ClaireEau Claire | 73 | $26,970 | $6,430 | $5,123 |
| Aurora Medical CenterSummit | 71 | $28,192 | $6,373 | $5,046 |
| Waukesha Memorial HospitalWaukesha | 60 | $41,946 | $6,517 | $5,191 |
| Froedtert Mem Lutheran HsptlMilwaukee | 60 | $44,708 | $6,732 | $5,364 |
| Froedtert SouthKenosha | 55 | $40,500 | $6,631 | $5,263 |
| Aurora Med Ctr Manitowoc CtyTwo Rivers | 55 | $34,295 | $6,407 | $5,104 |
| Mayo Clinic Health System-Franciscan Medical CenterLa Crosse | 51 | $22,105 | $6,397 | $5,054 |
| Aurora Med Ctr OshkoshOshkosh | 51 | $24,572 | $6,229 | $4,918 |
| Aurora Sheboygan Mem Med CtrSheboygan | 48 | $26,919 | $6,506 | $5,182 |
| St Marys Hsptl Med CtrGreen Bay | 48 | $36,715 | $6,220 | $4,913 |
| Aurora Memorial Hsptl BurlingtonBurlington | 40 | $28,834 | $6,728 | $5,361 |
| Thedacare Regional Med Ctr - NeenahNeenah | 38 | $23,978 | $6,133 | $4,832 |
| St Elizabeth HsptlAppleton | 37 | $29,789 | $6,438 | $5,126 |
| Mercy Hlth Sys CorpJanesville | 37 | $38,561 | $6,517 | $5,192 |
| St Agnes HsptlFond du Lac | 36 | $29,000 | $6,677 | $5,257 |
| Holy Family Memorial INCManitowoc | 36 | $40,058 | $6,434 | $5,124 |
| UW Hlth Partners - Watertown Regional Medical CtrWatertown | 36 | $35,106 | $6,373 | $5,048 |
| Beloit Mem HsptlBeloit | 34 | $58,145 | $6,958 | $5,540 |
| Aurora Med Center-Washington CountyHartford | 27 | $45,594 | $6,523 | $5,197 |
| Columbia St Marys Hsptl Milw (Col & Milw Campus)Milwaukee | 27 | $46,637 | $6,732 | $5,357 |
| Bay Area Med CtrMarinette | 25 | $36,052 | $6,668 | $5,268 |
| Wheaton Franciscan Healthcare- All SaintsRacine | 24 | $38,432 | $6,732 | $5,364 |
| Aurora West Allis Medical CenterWest Allis | 22 | $39,028 | $6,482 | $5,155 |
| Aspirus Rhinelander HospitalRhinelander | 20 | $21,531 | $6,856 | $5,462 |
| Ascension SE Wisconsin HospitalMilwaukee | 19 | $41,698 | $6,244 | $4,919 |
| Marshfield Medical Center - Rice LakeRice Lake | 18 | $27,003 | $6,856 | $5,462 |
| Aspirus Riverview Hospital & ClinicsWisconsin Rapids | 18 | $32,833 | $6,118 | $4,817 |
| Monroe ClinicMonroe | 16 | $30,470 | $6,678 | $5,315 |
| Oconomowoc Mem HsptlOconomowoc | 16 | $51,899 | $6,517 | $5,193 |
| Ministry St Michaels Hospital of Stevens PointStevens Point | 15 | $29,784 | $6,401 | $5,100 |
| St Vincent HsptlGreen Bay | 15 | $30,181 | $6,012 | $4,790 |
| Mile Bluff Medical Center, INCMauston | 15 | $24,098 | $6,856 | $5,462 |
| St Clare's Hospital of Weston INCWeston | 14 | $31,360 | $6,401 | $5,100 |
| SSM Health St Mary's Hospital - JanesvilleJanesville | 13 | $23,216 | $6,728 | $5,361 |
| St Clare Hsptl Hlth SvcsBaraboo | 12 | $22,422 | $6,523 | $5,197 |
| Sacred Heart HospitalEau Claire | – | – | – | – |
| Divine Savior HlthcarePortage | – | – | – | – |
| St Nicholas HospitalSheboygan | – | – | – | – |
| St Josephs Com Hsptl West BendWest Bend | – | – | – | – |
| Beaver Dam Com HsptlBeaver Dam | – | – | – | – |
| Wheaton Franciscan Healthcare- St FrancisMilwaukee | – | – | – | – |
| Howard Young Med CtrWoodruff | – | – | – | – |
| Aurora Lakeland Med CtrElkhorn | – | – | – | – |
| Marshfield Medical Center - MinocquaMinocqua | – | – | – | – |
Lowest and highest allowed amounts in Wisconsin
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
| St Vincent HsptlGreen Bay, WI | $6,012 |
|---|---|
| Aspirus Riverview Hospital & ClinicsWisconsin Rapids, WI | $6,118 |
| Thedacare Regional Med Ctr - NeenahNeenah, WI | $6,133 |
| Appleton Med CtrAppleton, WI | $6,210 |
| St Marys Hsptl Med CtrGreen Bay, WI | $6,220 |
Highest
| Beloit Mem HsptlBeloit, WI | $6,958 |
|---|---|
| Marshfield Medical Center - Rice LakeRice Lake, WI | $6,856 |
| Aspirus Rhinelander HospitalRhinelander, WI | $6,856 |
| Mile Bluff Medical Center, INCMauston, WI | $6,856 |
| Columbia St Marys Hsptl Milw (Col & Milw Campus)Milwaukee, WI | $6,732 |
Level 4 Musculoskeletal Procedures in other states
Questions
How much does level 4 musculoskeletal procedures cost in Wisconsin?
In 2024 Medicare data, level 4 musculoskeletal procedures (APC 5114) at 63 hospitals in Wisconsin was billed at $32,827 on average, while the average medicare-allowed amount was $6,482, of which Medicare paid $5,146. 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 Wisconsin, average charges were 5.1 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.