Level 5 Musculoskeletal Procedures in Pennsylvania
What 124 hospitals in Pennsylvania charged and were paid for level 5 musculoskeletal procedures (APC 5115), from 2024 Medicare claims.
Average charge
$63,606
Hospital list price billed
Average allowed
$12,207
Medicare's payment + patient's share
Medicare paid
$10,574
Average per service
State rank
#28 of 49
1 = lowest average payment
Hospitals in Pennsylvania billed an average of $63,606 for level 5 musculoskeletal procedures, about 5.2 times the average medicare-allowed amount of $12,207. That payment is 2% 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 $12,207Billed $63,606
About 19¢ was paid for every $1 hospitals in Pennsylvania billed for this service.
Pennsylvania hospitals: level 5 musculoskeletal procedures
Every Pennsylvania hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Lehigh Valley HospitalAllentown | 1,465 | $85,743 | $12,688 | $11,055 |
| Bucks County Specialty HospitalBensalem | 713 | $54,930 | $12,620 | $10,987 |
| Physicians Care Surgical HospitalRoyersford | 587 | $52,816 | $12,329 | $10,697 |
| UPMC Pinnacle HospitalsHarrisburg | 578 | $36,989 | $11,761 | $10,129 |
| Lancaster General HospitalLancaster | 477 | $36,954 | $12,047 | $10,415 |
| Riddle Memorial HospitalMedia | 441 | $40,196 | $12,717 | $11,085 |
| Oss Orthopaedic HospitalYork | 439 | $41,172 | $12,074 | $10,441 |
| Main Line Hospital Bryn Mawr CampusBryn Mawr | 409 | $40,387 | $12,678 | $11,046 |
| Lehigh Valley Hospital - Dickson CityDickson City | 405 | $75,060 | $11,531 | $9,899 |
| St Luke's Hospital BethlehemBethlehem | 372 | $90,665 | $12,473 | $10,843 |
| Thomas Jefferson University HospitalPhiladelphia | 359 | $58,314 | $12,390 | $10,757 |
| Evangelical Community HospitalLewisburg | 340 | $64,890 | $11,651 | $10,019 |
| Surgical Institute of ReadingWyomissing | 338 | $64,016 | $11,741 | $10,108 |
| Abington Memorial HospitalAbington | 323 | $35,474 | $12,264 | $10,630 |
| Reading Hospital and Med CtrWest Reading | 306 | $59,855 | $11,907 | $10,274 |
| Chester County HospitalWest Chester | 305 | $47,387 | $12,605 | $10,973 |
| Geisinger Wyoming Vly Med CtrWilkes-Barre | 305 | $113,596 | $11,640 | $10,007 |
| Mount Nittany Medical CenterState College | 297 | $64,637 | $13,181 | $11,549 |
| Grand View HospitalSellersville | 293 | $35,434 | $12,569 | $10,937 |
| AHN Wexford HospitalWexford | 289 | $51,229 | $11,635 | $10,001 |
| Geisinger-Community Medical CenterScranton | 277 | $111,320 | $11,630 | $9,998 |
| Robert Packer HospitalSayre | 243 | $42,716 | $12,031 | $10,398 |
| Edgewood Surgical HospitalTransfer | 233 | $55,533 | $11,740 | $10,107 |
| Lansdale HospitalLansdale | 232 | $34,526 | $12,329 | $10,694 |
| Saint Vincent Health CenterErie | 221 | $86,417 | $13,792 | $12,160 |
| UPMC PassavantPittsburgh | 218 | $77,952 | $11,694 | $10,060 |
| UPMC St MargaretPittsburgh | 215 | $76,709 | $11,693 | $10,061 |
| UPMC Presbyterian ShadysidePittsburgh | 213 | $96,644 | $11,598 | $9,964 |
| Penn Presbyterian Medical CenterPhiladelphia | 207 | $82,975 | $13,238 | $11,606 |
| Wellspan Surgery and Rehabilitation HospitalYork | 206 | $84,351 | $12,039 | $10,406 |
| St Clair Memorial HospitalPittsburgh | 197 | $54,240 | $11,740 | $10,108 |
| Milton S Hershey Medical CenterHershey | 192 | $125,332 | $12,203 | $10,570 |
| Holy Spirit HospitalCamp Hill | 188 | $117,322 | $11,627 | $9,995 |
| Magee Womens Hospital of UPMC Health SystemPittsburgh | 180 | $51,494 | $11,684 | $10,051 |
| Main Line Hospital LankenauWynnewood | 180 | $39,772 | $12,678 | $11,045 |
| Main Line Hospital PaoliPaoli | 177 | $42,200 | $12,615 | $10,983 |
| Chambersburg HospitalChambersburg | 165 | $41,404 | $12,834 | $11,195 |
| Penn State Health Lancaster Medical CenterLancaster | 162 | $114,650 | $11,524 | $9,891 |
| Williamsport Hospital & Medical CenterWilliamsport | 161 | $68,877 | $11,740 | $10,108 |
| Jefferson Health- NortheastPhiladelphia | 161 | $47,325 | $12,683 | $11,051 |
| Doylestown HospitalDoylestown | 159 | $50,223 | $12,540 | $10,905 |
| Wilkes-Barre General HospitalWilkes-Barre | 152 | $128,913 | $11,673 | $10,041 |
| Gettysburg HospitalGettysburg | 149 | $79,823 | $12,149 | $10,551 |
| Ephrata Community HospitalEphrata | 149 | $86,095 | $11,915 | $10,283 |
| Carlisle Regional Medical CtrCarlisle | 148 | $33,225 | $11,693 | $10,058 |
| Pennsylvania Hosp of the Univ of Pa Health SysPhiladelphia | 147 | $62,864 | $13,238 | $11,606 |
| Hanover HospitalHanover | 143 | $29,514 | $12,295 | $10,662 |
| Jefferson Regional Medical CenterClairton | 141 | $48,715 | $11,669 | $10,034 |
| Western Pennsylvania Hosp Forbes Regional CampusMonroeville | 141 | $39,951 | $11,668 | $10,034 |
| Heritage Valley SewickleySewickley | 136 | $29,718 | $11,666 | $10,034 |
| St Mary Medical CenterLanghorne | 135 | $65,286 | $12,979 | $11,345 |
| Hamot Medical CenterErie | 129 | $81,846 | $13,662 | $12,028 |
| Allegheny General HospitalPittsburgh | 128 | $59,728 | $11,345 | $9,713 |
| Geisinger Medical CenterDanville | 125 | $149,904 | $11,666 | $10,034 |
| Jefferson Einstein Montgomery HospitalEast Norriton | 121 | $59,365 | $12,064 | $10,432 |
| Holy Redeemer Hosp and Med CtrJenkintown | 116 | $36,381 | $12,329 | $10,697 |
| Butler Health SystemButler | 108 | $50,538 | $11,740 | $10,107 |
| Canonsburg General HospitalCanonsburg | 103 | $46,127 | $11,740 | $10,108 |
| UPMC EastMonroeville | 103 | $81,658 | $11,740 | $10,108 |
| UPMC LititzLititz | 102 | $38,390 | $11,814 | $10,182 |
| Meadville Medical CenterMeadville | 93 | $40,186 | $12,454 | $10,822 |
| Excela Health Westmoreland Regional HospitalGreensburg | 89 | $32,599 | $11,626 | $9,992 |
| Pottstown Memorial Med CenterPottstown | 88 | $68,093 | $12,218 | $10,586 |
| Easton HospitalEaston | 88 | $92,155 | $12,621 | $10,989 |
| Nason HospitalRoaring Spring | 87 | $46,780 | $11,508 | $9,876 |
| Temple University HospitalPhiladelphia | 84 | $137,605 | $12,965 | $11,330 |
| UPMC HorizonGreenville | 79 | $63,444 | $11,740 | $10,108 |
| Allegheny Valley HospitalNatrona Heights | 77 | $45,221 | $11,740 | $10,108 |
| Penn Highlands HuntingdonHuntingdon | 75 | $34,153 | $12,425 | $10,793 |
| St Luke's Quakertown HospitalQuakertown | 65 | $95,950 | $12,678 | $11,046 |
| Altoona Regional Health SystemAltoona | 63 | $46,656 | $12,397 | $10,765 |
| UPMC MemorialYork | 62 | $37,454 | $11,789 | $10,188 |
| Penn State Health Hampden Medical CenterEnola | 62 | $112,254 | $11,124 | $9,492 |
| Crozer Chester Medical CenterChester | 61 | $68,987 | $12,642 | $11,017 |
| Dubois Regional Medical CenterDubois | 56 | $34,199 | $12,571 | $10,939 |
| Hazleton General HospitalHazleton | 54 | $89,398 | $11,740 | $10,105 |
| St Luke's Hospital - Anderson CampusEaston | 52 | $104,964 | $11,979 | $10,347 |
| Indiana Regional Medical CenterIndiana | 51 | $39,870 | $12,378 | $10,744 |
| Warren General HospitalWarren | 49 | $26,127 | $13,847 | $12,214 |
| York HospitalYork | 46 | $79,435 | $12,137 | $10,500 |
| Lewistown HospitalLewistown | 46 | $49,724 | $12,400 | $10,783 |
| ACMH HospitalKittanning | 46 | $30,384 | $11,740 | $10,108 |
| Chestnut Hill HospitalPhiladelphia | 44 | $127,461 | $12,767 | $11,130 |
| Uniontown HospitalUniontown | 43 | $30,744 | $10,591 | $8,955 |
| Pocono Medical CenterEast Stroudsburg | 42 | $71,570 | $12,551 | $10,919 |
| Windber HospitalWindber | 40 | $36,906 | $11,740 | $10,102 |
| Heritage Valley BeaverBeaver | 39 | $35,220 | $11,481 | $9,849 |
| Latrobe Area HospitalLatrobe | 39 | $33,567 | $11,481 | $9,849 |
| Jameson Memorial HospitalNew Castle | 38 | $34,769 | $11,208 | $9,570 |
| Good Samaritan HospitalLebanon | 37 | $68,031 | $12,462 | $10,830 |
| Phoenixville HospitalPhoenixville | 34 | $58,611 | $12,678 | $11,039 |
| Conemaugh Valley Memorial HospitalJohnstown | 33 | $66,197 | $12,571 | $10,931 |
| Monongahela Valley HospitalMonongahela | 32 | $53,204 | $11,740 | $10,108 |
| Albert Einstein Medical CenterPhiladelphia | 26 | $67,959 | $12,767 | $11,135 |
| Grove City Medical CenterGrove City | 26 | $52,208 | $11,351 | $9,719 |
| Washington Hospital, theWashington | 25 | $43,612 | $11,740 | $10,108 |
| Advanced Surgical HospitalWashington | 25 | $56,798 | $10,546 | $8,890 |
| Somerset HospitalSomerset | 23 | $42,988 | $12,571 | $10,939 |
| St Joseph Medical CenterReading | 23 | $118,130 | $11,985 | $10,353 |
| St Luke's Hospital - Monroe CampusStroudsburg | 23 | $118,519 | $11,978 | $10,346 |
| Wayne Memorial HospitalHonesdale | 22 | $64,906 | $12,609 | $10,977 |
| Northwest Medical CenterOil City | 21 | $39,192 | $11,740 | $10,108 |
| Bloomsburg HospitalBloomsburg | 16 | $68,708 | $11,740 | $10,108 |
| St Luke's Hospital - Carbon CampusLehighton | 14 | $96,929 | $11,240 | $9,608 |
| Hospital of the Univ of PaPhiladelphia | 12 | $112,431 | $13,238 | $11,606 |
| UPMC MercyPittsburgh | – | – | – | – |
| Schuylkill Medical Center - South Jackson StreetPottsville | – | – | – | – |
| West Penn HospitalPittsburgh | – | – | – | – |
| Clarion HospitalClarion | – | – | – | – |
| UPMC KaneKane | – | – | – | – |
| Mercy Suburban HospitalNorristown | – | – | – | – |
| Waynesboro HospitalWaynesboro | – | – | – | – |
| Mercy Health SystemConshohocken | – | – | – | – |
| St Luke's Miners Memorial HospitalCoaldale | – | – | – | – |
| Highlands HospitalConnellsville | – | – | – | – |
| Fox Chase Cancer CenterPhiladelphia | – | – | – | – |
| Millcreek Community HospitalErie | – | – | – | – |
| Nazareth HospitalPhiladelphia | – | – | – | – |
| Sharon Regional Health SystemSharon | – | – | – | – |
| Excela Health Frick HospitalMt Pleasant | – | – | – | – |
| Mercy Hospital ScrantonScranton | – | – | – | – |
| Roxborough Memorial HospitalPhiladelphia | – | – | – | – |
| Geisinger St. Luke's HospitalOrwigsburg | – | – | – | – |
| Geisinger Medical Center MuncyMuncy | – | – | – | – |
Lowest and highest allowed amounts in Pennsylvania
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
| Advanced Surgical HospitalWashington, PA | $10,546 |
|---|---|
| Uniontown HospitalUniontown, PA | $10,591 |
| Penn State Health Hampden Medical CenterEnola, PA | $11,124 |
| Jameson Memorial HospitalNew Castle, PA | $11,208 |
| St Luke's Hospital - Carbon CampusLehighton, PA | $11,240 |
Highest
| Warren General HospitalWarren, PA | $13,847 |
|---|---|
| Saint Vincent Health CenterErie, PA | $13,792 |
| Hamot Medical CenterErie, PA | $13,662 |
| Hospital of the Univ of PaPhiladelphia, PA | $13,238 |
| Penn Presbyterian Medical CenterPhiladelphia, PA | $13,238 |
Level 5 Musculoskeletal Procedures in other states
Questions
How much does level 5 musculoskeletal procedures cost in Pennsylvania?
In 2024 Medicare data, level 5 musculoskeletal procedures (APC 5115) at 124 hospitals in Pennsylvania was billed at $63,606 on average, while the average medicare-allowed amount was $12,207, of which Medicare paid $10,574. 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 Pennsylvania, 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.