Level 5 Musculoskeletal Procedures in North Carolina
What 75 hospitals in North Carolina charged and were paid for level 5 musculoskeletal procedures (APC 5115), from 2024 Medicare claims.
Average charge
$61,099
Hospital list price billed
Average allowed
$11,652
Medicare's payment + patient's share
Medicare paid
$10,020
Average per service
State rank
#19 of 49
1 = lowest average payment
Hospitals in North Carolina billed an average of $61,099 for level 5 musculoskeletal procedures, about 5.2 times the average medicare-allowed amount of $11,652. That payment is 6% 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 $11,652Billed $61,099
About 19¢ was paid for every $1 hospitals in North Carolina billed for this service.
North Carolina hospitals: level 5 musculoskeletal procedures
Every North Carolina hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Rex HospitalRaleigh | 1,077 | $55,586 | $11,741 | $10,109 |
| New Hanover Regional Medical CenterWilmington | 730 | $59,683 | $12,161 | $10,530 |
| Carolina East Medical CenterNew Bern | 557 | $47,262 | $12,230 | $10,598 |
| Duke University Medical CenterDurham | 518 | $51,180 | $11,678 | $10,046 |
| Presbyterian HospitalCharlotte | 496 | $68,215 | $11,667 | $10,035 |
| Firsthealth Moore Regional HospitalPinehurst | 479 | $49,432 | $11,572 | $9,939 |
| Memorial Mission Hospital and Asheville Surgery CeAsheville | 441 | $88,901 | $11,284 | $9,649 |
| Carolinas Medical Center/Behav HealthCharlotte | 427 | $87,927 | $11,505 | $9,875 |
| North Carolina Eye & Ear HospDurham | 415 | $40,601 | $11,671 | $10,039 |
| Moses H Cone Memorial Hospital, theGreensboro | 389 | $44,297 | $11,739 | $10,107 |
| Margaret R Pardee Mem HospitalHendersonville | 385 | $42,809 | $11,210 | $9,576 |
| ECU Health Medical CenterGreenville | 354 | $43,039 | $11,360 | $9,731 |
| Atrium Health PinevilleCharlotte | 337 | $93,352 | $11,513 | $9,881 |
| Caromont Regional Medical CenterGastonia | 303 | $69,123 | $11,508 | $9,876 |
| North Carolina Baptist HospitalWinston-Salem | 299 | $82,517 | $11,611 | $9,978 |
| Duke Regional HospitalDurham | 252 | $50,843 | $11,653 | $10,021 |
| Watauga Medical CenterBoone | 247 | $45,451 | $12,163 | $10,531 |
| Catawba Valley Medical CenterHickory | 223 | $41,834 | $11,534 | $9,902 |
| Carolinas Medical Center-NortheastConcord | 214 | $81,689 | $11,668 | $10,036 |
| Forsyth Memorial HospitalWinston-Salem | 193 | $52,054 | $11,605 | $9,973 |
| Presbyterian Hospital HuntersvilleHuntersville | 187 | $83,093 | $11,702 | $10,070 |
| Haywood Regional Medical CenterClyde | 166 | $62,009 | $11,405 | $9,776 |
| Lake Norman Regional Medical CenterMooresville | 160 | $117,096 | $11,683 | $10,051 |
| Adventhealth HendersonvilleFletcher | 153 | $78,122 | $11,375 | $9,741 |
| Wakemed, Cary HospitalCary | 151 | $65,685 | $11,631 | $9,998 |
| Wakemed, Raleigh CampusRaleigh | 141 | $69,572 | $11,546 | $9,910 |
| Cape Fear Valley Medical CenterFayetteville | 135 | $45,909 | $11,327 | $9,695 |
| Albemarle Hospital AuthorityElizabeth City | 135 | $46,265 | $12,249 | $10,616 |
| Duke Health Raleigh HospitalRaleigh | 111 | $60,571 | $11,558 | $9,926 |
| Cape Fear Valley Hoke HospitalRaeford | 107 | $41,254 | $11,347 | $9,715 |
| Carolinas Medical Center-UnionMonroe | 106 | $84,366 | $11,235 | $9,603 |
| Alamance Regional Medical CenterBurlington | 105 | $51,040 | $11,903 | $10,271 |
| Carteret General HospitalMorehead City | 102 | $38,817 | $11,905 | $10,321 |
| UNC HospitalsChapel Hill | 101 | $42,287 | $11,386 | $9,754 |
| Iredell Memorial Hospital INCStatesville | 100 | $99,452 | $11,505 | $9,873 |
| High Point Regional Hlth SystHigh Point | 88 | $67,495 | $11,109 | $9,477 |
| Lexington Memorial Hospital INCLexington | 88 | $69,593 | $11,980 | $10,346 |
| Nash General HospitalRocky Mount | 88 | $38,969 | $11,092 | $9,460 |
| Cleveland Regional Medical CenterShelby | 85 | $81,309 | $11,451 | $9,819 |
| Wayne Memorial HospitalGoldsboro | 82 | $39,362 | $13,102 | $11,470 |
| Johnston Memorial HospitalSmithfield | 81 | $53,756 | $11,341 | $9,719 |
| Carolinas Med Ctr-UniversityCharlotte | 79 | $85,536 | $11,683 | $10,048 |
| Northern Hospital of Surry CountyMt Airy | 76 | $26,253 | $11,181 | $9,549 |
| Grace Hospital INCMorganton | 76 | $75,996 | $11,052 | $9,420 |
| Presbyterian Hospital-MatthewsMatthews | 69 | $79,001 | $11,516 | $9,884 |
| Hugh Chatham Memorial HospitalElkin | 65 | $40,119 | $11,439 | $9,807 |
| Davie Medical CenterBermuda Run | 65 | $81,983 | $11,821 | $10,189 |
| Brunswick Community HospitalSupply | 57 | $91,450 | $11,095 | $9,461 |
| Caldwell Memorial HospitalLenoir | 54 | $44,602 | $11,257 | $9,625 |
| Onslow Memorial HospitalJacksonville | 50 | $53,864 | $11,612 | $9,980 |
| ECU Health North HospitalRoanoke Rapids | 49 | $33,486 | $12,249 | $10,617 |
| C J Harris Community HospitalSylva | 47 | $78,117 | $11,231 | $9,593 |
| Frye Regional Medical CenterHickory | 43 | $103,503 | $11,688 | $10,056 |
| Scotland Memorial HospitalLaurinburg | 39 | $67,364 | $11,430 | $9,798 |
| Rowan Regional Medical CenterSalisbury | 37 | $75,764 | $11,260 | $9,628 |
| Vidant Edgecombe HospitalTarboro | 32 | $45,887 | $11,439 | $9,807 |
| Roanoke Chowan HospitalAhoskie | 29 | $34,389 | $12,249 | $10,617 |
| Wilkes Regional Medical CenterNorth Wilkesboro | 28 | $65,826 | $10,388 | $8,753 |
| Carolinas Medical Center-LincolnLincolnton | 25 | $85,805 | $11,811 | $10,179 |
| Randolph HospitalAsheboro | 18 | $54,345 | $11,791 | $10,159 |
| Granville Medical CenterOxford | 16 | $55,703 | $11,856 | $10,224 |
| Maria Parham HospitalHenderson | 15 | $91,015 | $10,785 | $9,153 |
| Medical Park HospitalWinston-Salem | 13 | $50,130 | $11,184 | $9,552 |
| Southeastern Regional Medical CenterLumberton | 11 | $72,247 | $12,249 | $10,617 |
| Betsy Johnson Regional HospitalDunn | 11 | $49,269 | $11,439 | $9,807 |
| Rutherford Hospital INCRutherfordton | – | – | – | – |
| Central Carolina HospitalSanford | – | – | – | – |
| Sampson Regional Medical CenterClinton | – | – | – | – |
| UNC RockinghamEden | – | – | – | – |
| Columbus Regional Healthcare SystemWhiteville | – | – | – | – |
| Thomasville Medical CenterThomasville | – | – | – | – |
| McDowell HospitalMarion | – | – | – | – |
| Wilson Medical CenterWilson | – | – | – | – |
| Novant Health Mint Hill Medical CenterCharlotte | – | – | – | – |
| Novant Health Ballantyne Medical CenterCharlotte | – | – | – | – |
Lowest and highest allowed amounts in North Carolina
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
| Wilkes Regional Medical CenterNorth Wilkesboro, NC | $10,388 |
|---|---|
| Maria Parham HospitalHenderson, NC | $10,785 |
| Grace Hospital INCMorganton, NC | $11,052 |
| Nash General HospitalRocky Mount, NC | $11,092 |
| Brunswick Community HospitalSupply, NC | $11,095 |
Highest
| Wayne Memorial HospitalGoldsboro, NC | $13,102 |
|---|---|
| Albemarle Hospital AuthorityElizabeth City, NC | $12,249 |
| Southeastern Regional Medical CenterLumberton, NC | $12,249 |
| Roanoke Chowan HospitalAhoskie, NC | $12,249 |
| ECU Health North HospitalRoanoke Rapids, NC | $12,249 |
Level 5 Musculoskeletal Procedures in other states
Questions
How much does level 5 musculoskeletal procedures cost in North Carolina?
In 2024 Medicare data, level 5 musculoskeletal procedures (APC 5115) at 75 hospitals in North Carolina was billed at $61,099 on average, while the average medicare-allowed amount was $11,652, of which Medicare paid $10,020. 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 North Carolina, average charges were 5.2 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.