Level 5 Musculoskeletal Procedures in Virginia
What 62 hospitals in Virginia charged and were paid for level 5 musculoskeletal procedures (APC 5115), from 2024 Medicare claims.
Average charge
$83,964
Hospital list price billed
Average allowed
$11,531
Medicare's payment + patient's share
Medicare paid
$9,914
Average per service
State rank
#15 of 49
1 = lowest average payment
Hospitals in Virginia billed an average of $83,964 for level 5 musculoskeletal procedures, about 7.3 times the average medicare-allowed amount of $11,531. That payment is 7% 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 $11,531Billed $83,964
About 14¢ was paid for every $1 hospitals in Virginia billed for this service.
Virginia hospitals: level 5 musculoskeletal procedures
Every Virginia hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Sentara Leigh HospitalNorfolk | 999 | $42,320 | $11,313 | $9,682 |
| University of Virginia Medical CenterCharlottesville | 751 | $44,958 | $8,957 | $7,600 |
| Inova Mount Vernon HospitalAlexandria | 706 | $41,684 | $12,158 | $10,524 |
| Carilion Medical CenterRoanoke | 662 | $73,197 | $11,171 | $9,538 |
| Cjw Medical CenterRichmond | 633 | $290,537 | $11,256 | $9,624 |
| Mary Immaculate HospitalNewport News | 567 | $72,944 | $11,199 | $9,566 |
| Augusta HealthFishersville | 539 | $79,526 | $12,558 | $10,926 |
| Bon Secours - St Marys Hospital of RichmondRichmond | 495 | $87,900 | $11,984 | $10,351 |
| Henrico Doctors' HospitalRichmond | 478 | $290,759 | $11,330 | $9,698 |
| Reston Hospital CenterReston | 467 | $100,110 | $12,201 | $10,570 |
| Virginia Hospital Center - ArlingtonArlington | 447 | $48,528 | $12,159 | $10,526 |
| Mary Washington Hospital, INCFredericksburg | 431 | $31,906 | $12,086 | $10,456 |
| Martha Jefferson HospitalCharlottesville | 372 | $32,971 | $11,196 | $9,564 |
| Inova Fair Oaks HospitalFairfax | 309 | $42,075 | $12,116 | $10,484 |
| Bon Secours - Memorial Regional MedicalMechanicsville | 297 | $75,828 | $11,892 | $10,260 |
| Sentara Bayside HospitalVirginia Beach | 294 | $43,593 | $11,275 | $9,647 |
| Bon Secours - St Francis Medical CenterMidlothian | 294 | $86,788 | $11,347 | $9,715 |
| Lewisgale Medical CenterSalem | 290 | $173,393 | $11,117 | $9,483 |
| Centra Health - Lynchburg Gen HospitalLynchburg | 289 | $63,116 | $12,082 | $10,449 |
| Winchester Medical Center INCWinchester | 267 | $34,167 | $12,584 | $10,952 |
| Inova Alexandria HospitalAlexandria | 265 | $41,400 | $12,001 | $10,369 |
| Medical College of Virginia HospitalsRichmond | 223 | $64,980 | $11,161 | $9,518 |
| Sentara Virginia Beach General HospitalVirginia Beach | 208 | $48,831 | $11,343 | $9,711 |
| Stonesprings Hospital CenterDulles | 189 | $102,150 | $12,044 | $10,412 |
| Sentara Obici HospitalSuffolk | 181 | $45,772 | $11,067 | $9,438 |
| Sentara Careplex HospitalHampton | 169 | $42,040 | $11,322 | $9,690 |
| Sentara Rmh Medical CenterHarrisonburg | 165 | $36,196 | $12,581 | $10,948 |
| UVA Health Haymarket Medical CenterHaymarket | 140 | $53,632 | $12,427 | $10,795 |
| The Fauquier Hospital, INCWarrenton | 123 | $112,055 | $12,237 | $10,605 |
| Chesapeake General HospitalChesapeake | 123 | $66,121 | $11,198 | $9,566 |
| Carilion New River Vly Med CtrChristiansburg | 121 | $88,406 | $11,159 | $9,524 |
| Montgomery Regional HospitalBlacksburg | 121 | $201,236 | $11,251 | $9,619 |
| Inova Loudoun HospitalLeesburg | 114 | $48,480 | $12,136 | $10,503 |
| Sentara Williamsburg Regional Medical CenterWilliamsburg | 112 | $42,962 | $11,232 | $9,600 |
| Southampton Memorial HospitalFranklin | 105 | $98,208 | $12,118 | $10,486 |
| Inova Fairfax HospitalFalls Church | 101 | $43,812 | $12,324 | $10,688 |
| Riverside Walter Reed HospitalGloucester | 97 | $37,719 | $11,318 | $9,686 |
| Spotsylvania Regional Medical CenterFredericksburg | 97 | $100,629 | $12,105 | $10,473 |
| Bon Secours - Maryview Medical CenterPortsmouth | 94 | $85,551 | $11,009 | $9,376 |
| Stafford Hospital CenterStafford | 90 | $39,270 | $12,089 | $10,454 |
| Sentara Northern Virginia Medical CenterWoodbridge | 85 | $44,251 | $12,324 | $10,692 |
| Warren Memorial HospitalFront Royal | 81 | $37,084 | $12,060 | $10,428 |
| Culpeper Regional HospitalCulpeper | 75 | $54,347 | $11,909 | $10,277 |
| John Randolph Medical CenterHopewell | 64 | $287,754 | $11,133 | $9,499 |
| Riverside Regional Medical CenterNewport News | 64 | $35,549 | $11,015 | $9,383 |
| Riverside Doctors' Hospital of WilliamsburgWilliamsburg | 64 | $38,045 | $11,167 | $9,535 |
| Danville Regional Medical CenterDanville | 63 | $146,715 | $11,679 | $10,047 |
| Johnston Memorial HospitalAbingdon | 62 | $81,163 | $10,536 | $8,904 |
| Smyth County Community HospitalMarion | 47 | $77,185 | $10,519 | $8,910 |
| Alleghany Regional HospitalJackson River | 40 | $126,237 | $12,118 | $10,486 |
| Sentara Norfolk General HospitalNorfolk | 27 | $56,788 | $11,074 | $9,442 |
| Community Memorial Healthcenter, INCSouth Hill | 19 | $60,336 | $12,247 | $10,610 |
| Twin County Regional HospitalGalax | 16 | $106,398 | $11,467 | $9,830 |
| Clinch Valley Medical CenterRichlands | 13 | $107,348 | $10,572 | $8,940 |
| Halifax Regional HospitalSouth Boston | 11 | $53,278 | $12,506 | $10,874 |
| Prince William HospitalManassas | – | – | – | – |
| Southside Regional Medical CenterPetersburg | – | – | – | – |
| Riverside Tappahannock HospitalTappahannock | – | – | – | – |
| Carilion Franklin Memorial HospitalRocky Mount | – | – | – | – |
| Southside Community Hospital, INCFarmville | – | – | – | – |
| Wythe County Community HospitalWytheville | – | – | – | – |
| Pulaski Community HospitalPulaski | – | – | – | – |
Lowest and highest allowed amounts in Virginia
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
| University of Virginia Medical CenterCharlottesville, VA | $8,957 |
|---|---|
| Smyth County Community HospitalMarion, VA | $10,519 |
| Johnston Memorial HospitalAbingdon, VA | $10,536 |
| Clinch Valley Medical CenterRichlands, VA | $10,572 |
| Bon Secours - Maryview Medical CenterPortsmouth, VA | $11,009 |
Highest
| Winchester Medical Center INCWinchester, VA | $12,584 |
|---|---|
| Sentara Rmh Medical CenterHarrisonburg, VA | $12,581 |
| Augusta HealthFishersville, VA | $12,558 |
| Halifax Regional HospitalSouth Boston, VA | $12,506 |
| UVA Health Haymarket Medical CenterHaymarket, VA | $12,427 |
Level 5 Musculoskeletal Procedures in other states
Questions
How much does level 5 musculoskeletal procedures cost in Virginia?
In 2024 Medicare data, level 5 musculoskeletal procedures (APC 5115) at 62 hospitals in Virginia was billed at $83,964 on average, while the average medicare-allowed amount was $11,531, of which Medicare paid $9,914. 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 Virginia, average charges were 7.3 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.