Level 5 Musculoskeletal Procedures in Delaware
What 6 hospitals in Delaware charged and were paid for level 5 musculoskeletal procedures (APC 5115), from 2024 Medicare claims.
Average charge
$42,292
Hospital list price billed
Average allowed
$13,085
Medicare's payment + patient's share
Medicare paid
$11,451
Average per service
State rank
#38 of 49
1 = lowest average payment
Hospitals in Delaware billed an average of $42,292 for level 5 musculoskeletal procedures, about 3.2 times the average medicare-allowed amount of $13,085. That payment is 6% above the U.S. average of $12,402.
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 $13,085Billed $42,292
About 31¢ was paid for every $1 hospitals in Delaware billed for this service.
Delaware hospitals: level 5 musculoskeletal procedures
Every Delaware hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Christiana Care Health Services, INC.Newark | 1,029 | $42,898 | $13,004 | $11,371 |
| Beebe Medical CenterLewes | 666 | $40,026 | $13,139 | $11,501 |
| Nanticoke Memorial HospitalSeaford | 373 | $31,160 | $13,184 | $11,551 |
| Bayhealth - Kent General HospitalDover | 134 | $64,292 | $13,103 | $11,471 |
| Bayhealth Hospital, Sussex CampusMilford | 121 | $52,394 | $13,184 | $11,552 |
| St Francis HospitalWilmington | 19 | $87,921 | $12,928 | $11,296 |
Lowest and highest allowed amounts in Delaware
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 Francis HospitalWilmington, DE | $12,928 |
|---|---|
| Christiana Care Health Services, INC.Newark, DE | $13,004 |
| Bayhealth - Kent General HospitalDover, DE | $13,103 |
| Beebe Medical CenterLewes, DE | $13,139 |
| Bayhealth Hospital, Sussex CampusMilford, DE | $13,184 |
Highest
| Nanticoke Memorial HospitalSeaford, DE | $13,184 |
|---|---|
| Bayhealth Hospital, Sussex CampusMilford, DE | $13,184 |
| Beebe Medical CenterLewes, DE | $13,139 |
| Bayhealth - Kent General HospitalDover, DE | $13,103 |
| Christiana Care Health Services, INC.Newark, DE | $13,004 |
Level 5 Musculoskeletal Procedures in other states
Questions
How much does level 5 musculoskeletal procedures cost in Delaware?
In 2024 Medicare data, level 5 musculoskeletal procedures (APC 5115) at 6 hospitals in Delaware was billed at $42,292 on average, while the average medicare-allowed amount was $13,085, of which Medicare paid $11,451. 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 Delaware, average charges were 3.2 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.