Level 5 Musculoskeletal Procedures in Wisconsin
What 61 hospitals in Wisconsin charged and were paid for level 5 musculoskeletal procedures (APC 5115), from 2024 Medicare claims.
Average charge
$50,252
Hospital list price billed
Average allowed
$11,921
Medicare's payment + patient's share
Medicare paid
$10,289
Average per service
State rank
#26 of 49
1 = lowest average payment
Hospitals in Wisconsin billed an average of $50,252 for level 5 musculoskeletal procedures, about 4.2 times the average medicare-allowed amount of $11,921. That payment is 4% 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 $11,921Billed $50,252
About 24¢ was paid for every $1 hospitals in Wisconsin billed for this service.
Wisconsin hospitals: level 5 musculoskeletal procedures
Every Wisconsin hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| University of Wi Hospitals & Clinics AuthorityMadison | 759 | $57,649 | $12,187 | $10,552 |
| Sauk Prairie Mem HsptlPrairie du Sac | 659 | $28,099 | $11,968 | $10,336 |
| Oconomowoc Mem HsptlOconomowoc | 403 | $62,134 | $11,922 | $10,290 |
| Oakleaf Surgical HospitalEau Claire | 376 | $38,281 | $11,736 | $10,106 |
| St Mary's HospitalMadison | 305 | $41,890 | $12,129 | $10,496 |
| Community Mem HsptlMenomonee Falls | 297 | $68,390 | $11,800 | $10,167 |
| Luther Hospital Mayo Health SystemEau Claire | 290 | $32,136 | $12,393 | $10,760 |
| Gundersen Luth Med CtrLa Crosse | 277 | $44,970 | $11,875 | $10,279 |
| Midwest Orthopedic Specialty Hospital, LLCFranklin | 257 | $50,552 | $11,733 | $10,095 |
| Bellin Memorial HsptlGreen Bay | 243 | $55,833 | $11,533 | $9,914 |
| Aurora St Lukes Medical CenterMilwaukee | 223 | $74,666 | $12,049 | $10,414 |
| Appleton Med CtrAppleton | 220 | $24,979 | $11,568 | $9,934 |
| Aurora Baycare Med CtrGreen Bay | 194 | $44,254 | $11,632 | $9,999 |
| Aspirus Wausau HospitalWausau | 193 | $44,542 | $11,446 | $9,814 |
| Aurora Medical CenterGrafton | 184 | $76,185 | $11,769 | $10,134 |
| Mayo Clinic Health System-Franciscan Medical CenterLa Crosse | 166 | $43,861 | $12,317 | $10,685 |
| St Marys Hsptl Med CtrGreen Bay | 161 | $46,917 | $11,631 | $9,997 |
| Orthopaedic Hsptl of WiGlendale | 141 | $70,358 | $11,462 | $9,828 |
| St Clare's Hospital of Weston INCWeston | 130 | $45,725 | $11,683 | $10,051 |
| Aurora Sheboygan Mem Med CtrSheboygan | 122 | $50,522 | $11,842 | $10,210 |
| Froedtert SouthKenosha | 111 | $56,249 | $12,360 | $10,728 |
| Fort HealthcareFort Atkinson | 106 | $31,457 | $11,974 | $10,342 |
| Aurora Med Ctr OshkoshOshkosh | 96 | $43,802 | $11,622 | $9,988 |
| Aurora Medical CenterSummit | 92 | $47,128 | $11,759 | $10,121 |
| Beloit Mem HsptlBeloit | 86 | $86,455 | $12,522 | $10,890 |
| Meriter HsptlMadison | 85 | $58,691 | $12,146 | $10,511 |
| Aurora West Allis Medical CenterWest Allis | 85 | $74,078 | $11,663 | $10,031 |
| St Elizabeth HsptlAppleton | 83 | $38,261 | $11,825 | $10,193 |
| Aurora Med Ctr KenoshaKenosha | 83 | $73,203 | $12,227 | $10,591 |
| Aurora Med Center-Washington CountyHartford | 81 | $77,529 | $11,984 | $10,352 |
| Marshfield Medical Center - Eau ClaireEau Claire | 77 | $40,340 | $11,814 | $10,182 |
| Aurora Med Ctr Manitowoc CtyTwo Rivers | 76 | $49,224 | $11,493 | $9,861 |
| Marshfield Medical CenterMarshfield | 76 | $43,622 | $12,450 | $10,818 |
| UW Hlth Partners - Watertown Regional Medical CtrWatertown | 75 | $69,419 | $11,974 | $10,341 |
| Ascension SE Wisconsin HospitalMilwaukee | 74 | $49,823 | $11,672 | $10,061 |
| St Josephs Com Hsptl West BendWest Bend | 65 | $66,477 | $11,815 | $10,182 |
| SSM Health St Mary's Hospital - JanesvilleJanesville | 65 | $41,459 | $12,360 | $10,728 |
| Holy Family Memorial INCManitowoc | 62 | $49,813 | $11,496 | $9,860 |
| Aspirus Rhinelander HospitalRhinelander | 59 | $44,539 | $12,594 | $10,962 |
| St Agnes HsptlFond du Lac | 54 | $43,346 | $12,656 | $11,024 |
| St Clare Hsptl Hlth SvcsBaraboo | 51 | $40,387 | $11,984 | $10,352 |
| Mercy Hlth Sys CorpJanesville | 47 | $81,624 | $11,534 | $9,902 |
| Ministry St Michaels Hospital of Stevens PointStevens Point | 43 | $38,513 | $11,292 | $9,658 |
| Monroe ClinicMonroe | 43 | $43,885 | $11,774 | $10,142 |
| St Nicholas HospitalSheboygan | 38 | $50,796 | $11,698 | $10,060 |
| Aurora Memorial Hsptl BurlingtonBurlington | 37 | $51,348 | $12,070 | $10,438 |
| Bay Area Med CtrMarinette | 36 | $55,163 | $12,346 | $10,714 |
| Froedtert Mem Lutheran HsptlMilwaukee | 36 | $76,954 | $12,068 | $10,436 |
| St Vincent HsptlGreen Bay | 34 | $47,719 | $11,834 | $10,202 |
| Divine Savior HlthcarePortage | 32 | $39,042 | $11,936 | $10,304 |
| Mile Bluff Medical Center, INCMauston | 31 | $45,421 | $12,594 | $10,962 |
| Waukesha Memorial HospitalWaukesha | 28 | $69,317 | $11,974 | $10,325 |
| Beaver Dam Com HsptlBeaver Dam | 25 | $61,775 | $11,984 | $10,352 |
| Wheaton Franciscan Healthcare- All SaintsRacine | 24 | $53,640 | $11,919 | $10,287 |
| Thedacare Regional Med Ctr - NeenahNeenah | 14 | $35,013 | $11,761 | $10,129 |
| Aurora Lakeland Med CtrElkhorn | 11 | $53,336 | $12,360 | $10,728 |
| Marshfield Medical Center - Rice LakeRice Lake | – | – | – | – |
| Sacred Heart HospitalEau Claire | – | – | – | – |
| Aspirus Riverview Hospital & ClinicsWisconsin Rapids | – | – | – | – |
| Columbia St Marys Hsptl Milw (Col & Milw Campus)Milwaukee | – | – | – | – |
| Wheaton Franciscan Healthcare- St FrancisMilwaukee | – | – | – | – |
Lowest and highest allowed amounts in Wisconsin
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
| Ministry St Michaels Hospital of Stevens PointStevens Point, WI | $11,292 |
|---|---|
| Aspirus Wausau HospitalWausau, WI | $11,446 |
| Orthopaedic Hsptl of WiGlendale, WI | $11,462 |
| Aurora Med Ctr Manitowoc CtyTwo Rivers, WI | $11,493 |
| Holy Family Memorial INCManitowoc, WI | $11,496 |
Highest
| St Agnes HsptlFond du Lac, WI | $12,656 |
|---|---|
| Aspirus Rhinelander HospitalRhinelander, WI | $12,594 |
| Mile Bluff Medical Center, INCMauston, WI | $12,594 |
| Beloit Mem HsptlBeloit, WI | $12,522 |
| Marshfield Medical CenterMarshfield, WI | $12,450 |
Level 5 Musculoskeletal Procedures in other states
Questions
How much does level 5 musculoskeletal procedures cost in Wisconsin?
In 2024 Medicare data, level 5 musculoskeletal procedures (APC 5115) at 61 hospitals in Wisconsin was billed at $50,252 on average, while the average medicare-allowed amount was $11,921, of which Medicare paid $10,289. 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 Wisconsin, average charges were 4.2 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.