Level 5 Musculoskeletal Procedures in Vermont
What 6 hospitals in Vermont charged and were paid for level 5 musculoskeletal procedures (APC 5115), from 2024 Medicare claims.
Average charge
$40,026
Hospital list price billed
Average allowed
$6,642
Medicare's payment + patient's share
Medicare paid
$5,011
Average per service
State rank
#1 of 49
1 = lowest average payment
Hospitals in Vermont billed an average of $40,026 for level 5 musculoskeletal procedures, about 6.0 times the average medicare-allowed amount of $6,642. That payment is 46% 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 $6,642Billed $40,026
About 17¢ was paid for every $1 hospitals in Vermont billed for this service.
Vermont hospitals: level 5 musculoskeletal procedures
Every Vermont hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Rutland Regional Medical CenterRutland | 295 | $42,729 | $7,060 | $5,428 |
| Fletcher Allen Hospital of VermontBurlington | 254 | $40,226 | $5,619 | $3,991 |
| Southwestern Vermont Medical CenterBennington | 111 | $42,104 | $8,811 | $7,179 |
| Brattleboro Memorial HospitalBrattleboro | 95 | $31,353 | $8,122 | $6,490 |
| Northwestern Medical CenterSt Albans | 92 | $41,290 | $5,983 | $4,351 |
| Central Vermont Medical CenterGraniteville-East Barre | 80 | $35,392 | $4,341 | $2,709 |
Lowest and highest allowed amounts in Vermont
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
| Central Vermont Medical CenterGraniteville-East Barre, VT | $4,341 |
|---|---|
| Fletcher Allen Hospital of VermontBurlington, VT | $5,619 |
| Northwestern Medical CenterSt Albans, VT | $5,983 |
| Rutland Regional Medical CenterRutland, VT | $7,060 |
| Brattleboro Memorial HospitalBrattleboro, VT | $8,122 |
Highest
| Southwestern Vermont Medical CenterBennington, VT | $8,811 |
|---|---|
| Brattleboro Memorial HospitalBrattleboro, VT | $8,122 |
| Rutland Regional Medical CenterRutland, VT | $7,060 |
| Northwestern Medical CenterSt Albans, VT | $5,983 |
| Fletcher Allen Hospital of VermontBurlington, VT | $5,619 |
Level 5 Musculoskeletal Procedures in other states
Questions
How much does level 5 musculoskeletal procedures cost in Vermont?
In 2024 Medicare data, level 5 musculoskeletal procedures (APC 5115) at 6 hospitals in Vermont was billed at $40,026 on average, while the average medicare-allowed amount was $6,642, of which Medicare paid $5,011. 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 Vermont, average charges were 6.0 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.