Level 5 Musculoskeletal Procedures in Massachusetts
What 50 hospitals in Massachusetts charged and were paid for level 5 musculoskeletal procedures (APC 5115), from 2024 Medicare claims.
Average charge
$35,515
Hospital list price billed
Average allowed
$13,997
Medicare's payment + patient's share
Medicare paid
$12,364
Average per service
State rank
#44 of 49
1 = lowest average payment
Hospitals in Massachusetts billed an average of $35,515 for level 5 musculoskeletal procedures, about 2.5 times the average medicare-allowed amount of $13,997. That payment is 13% 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 $13,997Billed $35,515
About 39¢ was paid for every $1 hospitals in Massachusetts billed for this service.
Massachusetts hospitals: level 5 musculoskeletal procedures
Every Massachusetts hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| New England Baptist HospitalBoston | 1,432 | $28,062 | $14,017 | $12,385 |
| Baystate Medical CenterSpringfield | 741 | $29,034 | $14,026 | $12,393 |
| Newton-Wellesley HospitalNewton Lower Falls | 675 | $32,683 | $13,980 | $12,347 |
| Massachusetts General HospitalBoston | 624 | $50,594 | $14,010 | $12,378 |
| Faulkner HospitalBoston | 552 | $34,573 | $13,999 | $12,366 |
| Cape Cod HospitalHyannis | 480 | $29,009 | $14,058 | $12,426 |
| Beth Israel Deaconess Hospital PlymouthPlymouth | 371 | $37,513 | $14,076 | $12,443 |
| South Shore HospitalSouth Weymouth | 286 | $21,439 | $14,030 | $12,400 |
| Winchester HospitalWinchester | 283 | $25,945 | $14,022 | $12,390 |
| Union HospitalLynn | 269 | $38,034 | $13,975 | $12,340 |
| Lowell General HospitalLowell | 247 | $27,201 | $13,959 | $12,326 |
| Lahey Clinic HospitalBurlington | 199 | $22,587 | $13,923 | $12,291 |
| Brigham and Women's HosptialBoston | 194 | $60,723 | $13,866 | $12,232 |
| Umass Memorial Medical Center INCWorcester | 187 | $62,738 | $13,796 | $12,163 |
| Southcoast Hospital Group, INCFall River | 186 | $43,077 | $13,979 | $12,347 |
| Berkshire Medical Center INCPittsfield | 172 | $42,894 | $14,740 | $13,108 |
| Emerson HospitalConcord | 170 | $30,115 | $14,110 | $12,477 |
| Beverly Hospital CorporationBeverly | 159 | $20,211 | $13,913 | $12,284 |
| St Vincent HospitalWorcester | 153 | $114,847 | $13,950 | $12,309 |
| Falmouth HospitalFalmouth | 152 | $29,860 | $14,028 | $12,396 |
| Milford Regional Medical CenterMilford | 147 | $24,188 | $14,040 | $12,413 |
| Cooley Dickinson Hospital Inc,TheNorthampton | 145 | $47,536 | $13,938 | $12,306 |
| Anna Jaques HospitalNewburyport | 143 | $22,703 | $13,935 | $12,303 |
| Sturdy Memorial HospitalAttleboro | 132 | $36,487 | $13,921 | $12,287 |
| Tufts Medical CenterBoston | 110 | $33,701 | $13,769 | $12,137 |
| Healthalliance Hospitals, INCLeominster | 102 | $63,180 | $13,987 | $12,353 |
| Holy Family Hospital, a Caritas Family HospitalMethuen | 101 | $36,330 | $13,742 | $12,109 |
| Morton Hospital & Medical CenterTaunton | 97 | $35,994 | $13,852 | $12,219 |
| Melrosewakefield HealthcareMelrose | 87 | $27,796 | $13,967 | $12,334 |
| Lawrence General HospitalLawrence | 73 | $29,227 | $14,110 | $12,478 |
| Marlborough HospitalMarlborough | 70 | $67,367 | $13,932 | $12,299 |
| Good Samaritan Medical Center, a Caritas Family HoBrockton | 70 | $41,983 | $13,693 | $12,075 |
| Mercy Medical CenterSpringfield | 67 | $29,625 | $13,737 | $12,101 |
| Mount Auburn HospitalCambridge | 64 | $18,235 | $13,915 | $12,282 |
| Saint Anne's Hospital, a Caritas Family HospitalFall River | 62 | $42,324 | $13,810 | $12,173 |
| Beth Israel Deaconess Hospital - NeedhamNeedham | 60 | $24,511 | $13,902 | $12,270 |
| Heywood HospitalGardner | 57 | $33,367 | $14,110 | $12,478 |
| Boston Medical Center CorporationBoston | 54 | $42,997 | $13,879 | $12,247 |
| Beth Israel Deaconess Medical CenterBoston | 51 | $27,580 | $14,110 | $12,478 |
| Holyoke Medical CenterHolyoke | 48 | $35,885 | $14,110 | $12,478 |
| Harrington Memorial HospitalSouthbridge | 46 | $50,063 | $13,838 | $12,206 |
| Cambridge Health AllianceCambridge | 34 | $15,824 | $13,750 | $12,108 |
| Boston Medical Center-BrightonBrighton | 30 | $40,392 | $13,698 | $12,066 |
| Carney HospitalDorchester | – | – | – | – |
| Wing Memorial Hospital and Medical CenterPalmer | – | – | – | – |
| Noble HospitalWestfield | – | – | – | – |
| Massachusetts Eye and Ear InfirmaryBoston | – | – | – | – |
| Nashoba Valley Medical CenterAyer | – | – | – | – |
| Milton HospitalMilton | – | – | – | – |
| Metrowest Medical CenterFramingham | – | – | – | – |
Lowest and highest allowed amounts in Massachusetts
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
| Good Samaritan Medical Center, a Caritas Family HoBrockton, MA | $13,693 |
|---|---|
| Boston Medical Center-BrightonBrighton, MA | $13,698 |
| Mercy Medical CenterSpringfield, MA | $13,737 |
| Holy Family Hospital, a Caritas Family HospitalMethuen, MA | $13,742 |
| Cambridge Health AllianceCambridge, MA | $13,750 |
Highest
| Berkshire Medical Center INCPittsfield, MA | $14,740 |
|---|---|
| Emerson HospitalConcord, MA | $14,110 |
| Lawrence General HospitalLawrence, MA | $14,110 |
| Holyoke Medical CenterHolyoke, MA | $14,110 |
| Beth Israel Deaconess Medical CenterBoston, MA | $14,110 |
Level 5 Musculoskeletal Procedures in other states
Questions
How much does level 5 musculoskeletal procedures cost in Massachusetts?
In 2024 Medicare data, level 5 musculoskeletal procedures (APC 5115) at 50 hospitals in Massachusetts was billed at $35,515 on average, while the average medicare-allowed amount was $13,997, of which Medicare paid $12,364. 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 Massachusetts, average charges were 2.5 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.