Level 5 Musculoskeletal Procedures in South Dakota
What 14 hospitals in South Dakota charged and were paid for level 5 musculoskeletal procedures (APC 5115), from 2024 Medicare claims.
Average charge
$48,585
Hospital list price billed
Average allowed
$12,387
Medicare's payment + patient's share
Medicare paid
$10,755
Average per service
State rank
#31 of 49
1 = lowest average payment
Hospitals in South Dakota billed an average of $48,585 for level 5 musculoskeletal procedures, about 3.9 times the average medicare-allowed amount of $12,387. 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 $12,387Billed $48,585
About 25¢ was paid for every $1 hospitals in South Dakota billed for this service.
South Dakota hospitals: level 5 musculoskeletal procedures
Every South 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 |
|---|---|---|---|---|
| Sioux Falls Surgical Hospital LLPSioux Falls | 1,213 | $45,509 | $12,287 | $10,655 |
| Avera McKennan Hospital & University Health CenterSioux Falls | 586 | $56,353 | $12,213 | $10,580 |
| Dunes Surgical HospitalNorth Sioux City | 485 | $44,549 | $12,300 | $10,668 |
| Sanford Usd Medical CenterSioux Falls | 364 | $52,934 | $12,083 | $10,451 |
| Black Hills Surgical Hospital LLPRapid City | 286 | $44,521 | $12,099 | $10,467 |
| Avera St LukesAberdeen | 168 | $46,156 | $12,258 | $10,626 |
| Avera Sacred Heart HospitalYankton | 158 | $46,115 | $13,048 | $11,415 |
| Spearfish Regional HospitalSpearfish | 155 | $60,504 | $13,194 | $11,559 |
| Rapid City Regional HospitalRapid City | 151 | $54,984 | $12,967 | $11,334 |
| Prairie Lakes Hosp & Care CtrWatertown | 111 | $47,286 | $12,882 | $11,250 |
| St Mary's Healthcare CenterPierre | 91 | $50,717 | $13,067 | $11,435 |
| Brookings HospitalBrookings | 60 | $29,135 | $13,194 | $11,562 |
| Sanford Medical Center AberdeenAberdeen | 39 | $43,952 | $12,322 | $10,690 |
| Same Day Surgery Center LLCRapid City | – | – | – | – |
Lowest and highest allowed amounts in South 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
| Sanford Usd Medical CenterSioux Falls, SD | $12,083 |
|---|---|
| Black Hills Surgical Hospital LLPRapid City, SD | $12,099 |
| Avera McKennan Hospital & University Health CenterSioux Falls, SD | $12,213 |
| Avera St LukesAberdeen, SD | $12,258 |
| Sioux Falls Surgical Hospital LLPSioux Falls, SD | $12,287 |
Highest
| Spearfish Regional HospitalSpearfish, SD | $13,194 |
|---|---|
| Brookings HospitalBrookings, SD | $13,194 |
| St Mary's Healthcare CenterPierre, SD | $13,067 |
| Avera Sacred Heart HospitalYankton, SD | $13,048 |
| Rapid City Regional HospitalRapid City, SD | $12,967 |
Level 5 Musculoskeletal Procedures in other states
Questions
How much does level 5 musculoskeletal procedures cost in South Dakota?
In 2024 Medicare data, level 5 musculoskeletal procedures (APC 5115) at 14 hospitals in South Dakota was billed at $48,585 on average, while the average medicare-allowed amount was $12,387, of which Medicare paid $10,755. 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 South Dakota, average charges were 3.9 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.