Level 5 Musculoskeletal Procedures in West Virginia
What 22 hospitals in West Virginia charged and were paid for level 5 musculoskeletal procedures (APC 5115), from 2024 Medicare claims.
Average charge
$56,053
Hospital list price billed
Average allowed
$11,015
Medicare's payment + patient's share
Medicare paid
$9,383
Average per service
State rank
#6 of 49
1 = lowest average payment
Hospitals in West Virginia billed an average of $56,053 for level 5 musculoskeletal procedures, about 5.1 times the average medicare-allowed amount of $11,015. That payment is 11% 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 $11,015Billed $56,053
About 20¢ was paid for every $1 hospitals in West Virginia billed for this service.
West Virginia hospitals: level 5 musculoskeletal procedures
Every West 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 |
|---|---|---|---|---|
| United Hospital CenterBridgeport | 262 | $51,975 | $12,095 | $10,463 |
| Thomas Memorial HospitalSouth Charleston | 256 | $50,386 | $10,884 | $9,252 |
| Cabell-Huntington Hospital INCHuntington | 250 | $65,301 | $11,083 | $9,451 |
| Princeton Community HospitalPrinceton | 198 | $55,398 | $11,294 | $9,660 |
| Camden Clark Memorial HospitalParkersburg | 154 | $42,073 | $10,897 | $9,265 |
| St Mary's Medical CenterHuntington | 132 | $50,987 | $10,836 | $9,204 |
| Mon Health Medical CenterMorgantown | 125 | $69,531 | $11,059 | $9,427 |
| West Virginia University HospitalsMorgantown | 124 | $63,818 | $10,275 | $8,649 |
| Charleston Area Medical CenterCharleston | 81 | $83,304 | $10,500 | $8,868 |
| Camc Charleston Surgical HospitalCharleston | 81 | $23,849 | $10,440 | $8,806 |
| Reynolds Memorial HospitalGlen Dale | 58 | $54,209 | $9,800 | $8,167 |
| Saint Francis HospitalCharleston | 50 | $62,723 | $10,576 | $8,941 |
| Wheeling HospitalWheeling | 50 | $55,344 | $10,437 | $8,805 |
| Berkeley Medical CenterMartinsburg | 47 | $55,276 | $11,402 | $9,770 |
| Raleigh General HospitalBeckley | 45 | $78,765 | $10,809 | $9,193 |
| Davis Memorial HospitalElkins | 44 | $49,241 | $11,176 | $9,544 |
| Beckley Arh HospitalBeckley | 31 | $44,341 | $11,144 | $9,512 |
| Weirton Medical CenterWeirton | 30 | $75,996 | $10,999 | $9,367 |
| Rivers HealthPoint Pleasant | 15 | $42,722 | $10,742 | $9,102 |
| Greenbrier Valley Medical CenterRonceverte | – | – | – | – |
| Stonewall Jackson Mem HospWeston | – | – | – | – |
| Logan Regional Medical CenterLogan | – | – | – | – |
Lowest and highest allowed amounts in West 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
| Reynolds Memorial HospitalGlen Dale, WV | $9,800 |
|---|---|
| West Virginia University HospitalsMorgantown, WV | $10,275 |
| Wheeling HospitalWheeling, WV | $10,437 |
| Camc Charleston Surgical HospitalCharleston, WV | $10,440 |
| Charleston Area Medical CenterCharleston, WV | $10,500 |
Highest
| United Hospital CenterBridgeport, WV | $12,095 |
|---|---|
| Berkeley Medical CenterMartinsburg, WV | $11,402 |
| Princeton Community HospitalPrinceton, WV | $11,294 |
| Davis Memorial HospitalElkins, WV | $11,176 |
| Beckley Arh HospitalBeckley, WV | $11,144 |
Level 5 Musculoskeletal Procedures in other states
Questions
How much does level 5 musculoskeletal procedures cost in West Virginia?
In 2024 Medicare data, level 5 musculoskeletal procedures (APC 5115) at 22 hospitals in West Virginia was billed at $56,053 on average, while the average medicare-allowed amount was $11,015, of which Medicare paid $9,383. 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 West Virginia, average charges were 5.1 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.