Level 5 Musculoskeletal Procedures in North Dakota
What 6 hospitals in North Dakota charged and were paid for level 5 musculoskeletal procedures (APC 5115), from 2024 Medicare claims.
Average charge
$38,474
Hospital list price billed
Average allowed
$12,448
Medicare's payment + patient's share
Medicare paid
$10,816
Average per service
State rank
#32 of 49
1 = lowest average payment
Hospitals in North Dakota billed an average of $38,474 for level 5 musculoskeletal procedures, about 3.1 times the average medicare-allowed amount of $12,448. That payment is about the same as 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 $12,448Billed $38,474
About 32¢ was paid for every $1 hospitals in North Dakota billed for this service.
North Dakota hospitals: level 5 musculoskeletal procedures
Every North Dakota hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Sanford Medical Center FargoFargo | 618 | $35,621 | $12,304 | $10,672 |
| St Alexius Medical CenterBismarck | 418 | $35,579 | $12,245 | $10,613 |
| Altru Health SystemGrand Forks | 270 | $53,649 | $12,942 | $11,310 |
| Essentia Health-FargoFargo | 248 | $37,215 | $12,236 | $10,603 |
| Sanford Medical Center BismarckBismarck | 219 | $35,206 | $12,322 | $10,690 |
| Trinity HospitalsMinot | 162 | $37,879 | $13,194 | $11,560 |
Lowest and highest allowed amounts in North Dakota
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
| Essentia Health-FargoFargo, ND | $12,236 |
|---|---|
| St Alexius Medical CenterBismarck, ND | $12,245 |
| Sanford Medical Center FargoFargo, ND | $12,304 |
| Sanford Medical Center BismarckBismarck, ND | $12,322 |
| Altru Health SystemGrand Forks, ND | $12,942 |
Highest
| Trinity HospitalsMinot, ND | $13,194 |
|---|---|
| Altru Health SystemGrand Forks, ND | $12,942 |
| Sanford Medical Center BismarckBismarck, ND | $12,322 |
| Sanford Medical Center FargoFargo, ND | $12,304 |
| St Alexius Medical CenterBismarck, ND | $12,245 |
Level 5 Musculoskeletal Procedures in other states
Questions
How much does level 5 musculoskeletal procedures cost in North Dakota?
In 2024 Medicare data, level 5 musculoskeletal procedures (APC 5115) at 6 hospitals in North Dakota was billed at $38,474 on average, while the average medicare-allowed amount was $12,448, of which Medicare paid $10,816. 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 Dakota, average charges were 3.1 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.