Level 5 Musculoskeletal Procedures in Kentucky
What 50 hospitals in Kentucky charged and were paid for level 5 musculoskeletal procedures (APC 5115), from 2024 Medicare claims.
Average charge
$87,551
Hospital list price billed
Average allowed
$11,263
Medicare's payment + patient's share
Medicare paid
$9,630
Average per service
State rank
#11 of 49
1 = lowest average payment
Hospitals in Kentucky billed an average of $87,551 for level 5 musculoskeletal procedures, about 7.8 times the average medicare-allowed amount of $11,263. That payment is 9% 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 $11,263Billed $87,551
About 13¢ was paid for every $1 hospitals in Kentucky billed for this service.
Kentucky hospitals: level 5 musculoskeletal procedures
Every Kentucky hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Baptist Hospital EastLouisville | 775 | $102,617 | $11,175 | $9,542 |
| Norton Healthcare PavilionLouisville | 639 | $139,645 | $11,074 | $9,440 |
| Hardin Memorial HospitalElizabethtown | 283 | $105,086 | $10,983 | $9,349 |
| Jewish HospitalLouisville | 277 | $73,443 | $11,068 | $9,438 |
| Central Baptist HospitalLexington | 275 | $112,466 | $11,207 | $9,571 |
| St Elizabeth FlorenceFlorence | 239 | $39,563 | $11,076 | $9,443 |
| Greenview Regional HospitalBowling Green | 226 | $74,716 | $11,272 | $9,639 |
| Pikeville Medical CenterPikeville | 216 | $58,461 | $11,795 | $10,163 |
| Owensboro Medical Health SystemOwensboro | 184 | $82,341 | $12,046 | $10,409 |
| Lourdes HospitalPaducah | 170 | $64,617 | $12,025 | $10,388 |
| University of Kentucky HospLexington | 169 | $50,967 | $11,191 | $9,579 |
| Saint Joseph HospitalLexington | 165 | $33,341 | $11,266 | $9,633 |
| Ephraim McDowell Regional Medical CenterDanville | 114 | $47,367 | $11,059 | $9,427 |
| Western Baptist HospitalPaducah | 110 | $131,947 | $11,647 | $10,008 |
| Baptist Health Deaconess MadisonvilleMadisonville | 100 | $185,353 | $12,054 | $10,422 |
| Baptist Hospital NortheastLa Grange | 100 | $111,855 | $11,326 | $9,690 |
| The Medical Center at Bowling GreenBowling Green | 97 | $73,721 | $11,257 | $9,625 |
| Jennie Stuart Medical CenterHopkinsville | 91 | $50,906 | $11,698 | $10,065 |
| King's Daughters' Medical CenterAshland | 88 | $51,011 | $10,872 | $9,237 |
| Saint Joseph EastLexington | 80 | $37,968 | $11,140 | $9,505 |
| Murray-Calloway County HospitalMurray | 69 | $43,547 | $10,901 | $9,268 |
| St Elizabeth Med Center-SouthEdgewood | 62 | $43,623 | $10,557 | $8,917 |
| Flaget Memorial HospitalBardstown | 61 | $50,556 | $11,167 | $9,535 |
| Clark Regional Medical CenterWinchester | 55 | $90,461 | $11,206 | $9,574 |
| Saint Joseph Mount SterlingMt Sterling | 49 | $32,070 | $11,044 | $9,412 |
| Jackson Purchase Medical CenterMayfield | 49 | $123,103 | $11,812 | $10,180 |
| Lake Cumberland Regional HospitalSomerset | 49 | $135,405 | $11,473 | $9,836 |
| Saint Joseph LondonLondon | 46 | $46,102 | $10,825 | $9,188 |
| T J Samson Community HospitalGlasgow | 44 | $45,948 | $11,682 | $10,069 |
| Georgetown Community HospitalGeorgetown | 32 | $104,595 | $11,432 | $9,790 |
| Meadowview Regional Medical CenterMaysville | 20 | $107,030 | $11,810 | $10,178 |
| Taylor Regional HospitalCampbellsville | 19 | $45,976 | $10,538 | $8,903 |
| Twin Lakes Regional Medical CenterLeitchfield | 17 | $50,595 | $11,029 | $9,397 |
| St Claire Regional Medical CenterMorehead | 16 | $56,284 | $12,115 | $10,483 |
| Bourbon Community HospitalParis | 16 | $101,269 | $10,327 | $8,695 |
| Deaconess Henderson HospitalHenderson | 16 | $38,293 | $11,578 | $9,946 |
| Highlands Regional Medical CenterPrestonsburg | 15 | $44,064 | $9,880 | $8,243 |
| Baptist Health RichmondRichmond | 14 | $105,663 | $10,622 | $8,990 |
| Jewish Hospital - ShelbyvilleShelbyville | 13 | $56,358 | $10,580 | $8,948 |
| University of Louisville HospitalLouisville | 13 | $72,002 | $11,170 | $9,532 |
| Spring View HospitalLebanon | 12 | $72,725 | $11,029 | $9,397 |
| Frankfort Regional Medical CenterFrankfort | 12 | $93,880 | $10,816 | $9,184 |
| St Elizabeth Ft ThomasFort Thomas | – | – | – | – |
| Muhlenberg Community HospitalGreenville | – | – | – | – |
| Hazard Arh Regional Medical CenterHazard | – | – | – | – |
| Memorial HospitalManchester | – | – | – | – |
| Williamson Arh HospitalSouth Williamson | – | – | – | – |
| Harrison Memorial HospitalCynthiana | – | – | – | – |
| Baptist Regional Medical CtrCorbin | – | – | – | – |
| Three Rivers Medical CenterLouisa | – | – | – | – |
Lowest and highest allowed amounts in Kentucky
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
| Highlands Regional Medical CenterPrestonsburg, KY | $9,880 |
|---|---|
| Bourbon Community HospitalParis, KY | $10,327 |
| Taylor Regional HospitalCampbellsville, KY | $10,538 |
| St Elizabeth Med Center-SouthEdgewood, KY | $10,557 |
| Jewish Hospital - ShelbyvilleShelbyville, KY | $10,580 |
Highest
| St Claire Regional Medical CenterMorehead, KY | $12,115 |
|---|---|
| Baptist Health Deaconess MadisonvilleMadisonville, KY | $12,054 |
| Owensboro Medical Health SystemOwensboro, KY | $12,046 |
| Lourdes HospitalPaducah, KY | $12,025 |
| Jackson Purchase Medical CenterMayfield, KY | $11,812 |
Level 5 Musculoskeletal Procedures in other states
Questions
How much does level 5 musculoskeletal procedures cost in Kentucky?
In 2024 Medicare data, level 5 musculoskeletal procedures (APC 5115) at 50 hospitals in Kentucky was billed at $87,551 on average, while the average medicare-allowed amount was $11,263, of which Medicare paid $9,630. 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 Kentucky, average charges were 7.8 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.