Level 5 Musculoskeletal Procedures in Iowa
What 31 hospitals in Iowa charged and were paid for level 5 musculoskeletal procedures (APC 5115), from 2024 Medicare claims.
Average charge
$49,145
Hospital list price billed
Average allowed
$11,405
Medicare's payment + patient's share
Medicare paid
$9,772
Average per service
State rank
#13 of 49
1 = lowest average payment
Hospitals in Iowa billed an average of $49,145 for level 5 musculoskeletal procedures, about 4.3 times the average medicare-allowed amount of $11,405. That payment is 8% below 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 $11,405Billed $49,145
About 23¢ was paid for every $1 hospitals in Iowa billed for this service.
Iowa hospitals: level 5 musculoskeletal procedures
Every Iowa hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Iowa Methodist Medical CenterDes Moines | 1,145 | $57,163 | $11,208 | $9,574 |
| Mercy HospitalIowa City | 683 | $52,045 | $11,613 | $9,980 |
| Mercy Medical Center-Des MoinesDes Moines | 499 | $47,350 | $11,168 | $9,536 |
| Mercy Medical Center - Cedar RapidsCedar Rapids | 386 | $42,241 | $11,286 | $9,654 |
| Mary Greeley Medical CenterAmes | 354 | $36,354 | $11,234 | $9,602 |
| Mercy Medical Center-DubuqueDubuque | 350 | $40,994 | $11,925 | $10,291 |
| University of Iowa Hospital & ClinicsIowa City | 344 | $59,924 | $11,534 | $9,902 |
| St Lukes HospitalCedar Rapids | 319 | $45,361 | $11,245 | $9,612 |
| Genesis Medical Center-DavenportDavenport | 285 | $41,045 | $11,085 | $9,450 |
| The Finley HospitalDubuque | 205 | $47,848 | $11,151 | $9,518 |
| Mercy Medical Center-North IowaMason City | 193 | $57,621 | $12,565 | $10,932 |
| Spencer Municipal HospitalSpencer | 189 | $37,855 | $11,144 | $9,511 |
| Allen Memorial HospitalWaterloo | 116 | $42,855 | $11,079 | $9,447 |
| Sartori Memorial HospitalCedar Falls | 112 | $87,573 | $11,080 | $9,447 |
| Jennie Edmundson HospitalCouncil Bluffs | 110 | $37,753 | $11,751 | $10,119 |
| Southeast Iowa Regional Medical CenterWest Burlington | 99 | $40,186 | $11,935 | $10,301 |
| Lakes Regional HealthcareSpirit Lake | 66 | $39,672 | $11,245 | $9,613 |
| Trinity Medical CenterDavenport | 59 | $44,828 | $11,100 | $9,468 |
| Ottumwa Regional Health CenterOttumwa | 51 | $54,977 | $12,138 | $10,503 |
| Marshalltown Medical & Surgical CenterMarshalltown | 48 | $45,940 | $12,082 | $10,450 |
| Trinity Regional Medical CenterFort Dodge | 47 | $50,984 | $12,041 | $10,409 |
| Alegent Health Mercy HospitalCouncil Bluffs | 40 | $54,402 | $11,333 | $9,701 |
| Broadlawns Medical CenterDes Moines | 23 | $28,694 | $11,283 | $9,651 |
| Mercyone Siouxland Medical CenterSioux City | 22 | $49,392 | $11,844 | $10,212 |
| Grinnell Regional Medical CenterGrinnell | 19 | $50,188 | $11,283 | $9,651 |
| St Lukes Regional Medical CenterSioux City | 17 | $51,961 | $11,278 | $9,646 |
| Mercyone Newton Medical CenterNewton | 16 | $45,054 | $11,283 | $9,651 |
| Trinity MuscatineMuscatine | 15 | $43,760 | $12,041 | $10,409 |
| St Anthony Regional Hospital & Nursing HomeCarroll | 13 | $41,528 | $12,041 | $10,409 |
| Mercyone Waterloo Medical CenterWaterloo | – | – | – | – |
| Mercy Medical Center-ClintonClinton | – | – | – | – |
Lowest and highest allowed amounts in Iowa
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
| Allen Memorial HospitalWaterloo, IA | $11,079 |
|---|---|
| Sartori Memorial HospitalCedar Falls, IA | $11,080 |
| Genesis Medical Center-DavenportDavenport, IA | $11,085 |
| Trinity Medical CenterDavenport, IA | $11,100 |
| Spencer Municipal HospitalSpencer, IA | $11,144 |
Highest
| Mercy Medical Center-North IowaMason City, IA | $12,565 |
|---|---|
| Ottumwa Regional Health CenterOttumwa, IA | $12,138 |
| Marshalltown Medical & Surgical CenterMarshalltown, IA | $12,082 |
| St Anthony Regional Hospital & Nursing HomeCarroll, IA | $12,041 |
| Trinity MuscatineMuscatine, IA | $12,041 |
Level 5 Musculoskeletal Procedures in other states
Questions
How much does level 5 musculoskeletal procedures cost in Iowa?
In 2024 Medicare data, level 5 musculoskeletal procedures (APC 5115) at 31 hospitals in Iowa was billed at $49,145 on average, while the average medicare-allowed amount was $11,405, of which Medicare paid $9,772. 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 Iowa, average charges were 4.3 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.