Level 6 Musculoskeletal Procedures
What 2,342 hospitals in the U.S. charged and were paid for level 6 musculoskeletal procedures (APC 5116), from 2024 Medicare claims.
Average charge
$97,523
Hospital list price billed
Average allowed
$17,392
Medicare's payment + patient's share
Medicare paid
$15,763
Average per service
Volume
73,440
Medicare services
Hospitals in the U.S. billed an average of $97,523 for level 6 musculoskeletal procedures, about 5.6 times the average medicare-allowed amount of $17,392.
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 $17,392Billed $97,523
About 18¢ was paid for every $1 hospitals in the U.S. billed for this service.
Lowest and highest allowed amounts
Among hospitals with at least 20 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| McKay-Dee Hospital CenterOgden, UT | $2,990 |
|---|---|
| Rutland Regional Medical CenterRutland, VT | $8,448 |
| Fletcher Allen Hospital of VermontBurlington, VT | $8,459 |
| Vanderbilt University HospitalNashville, TN | $8,954 |
| Townsen Memorial HospitalHumble, TX | $10,496 |
| Carteret General HospitalMorehead City, NC | $11,156 |
| Piedmont Healthcare SystemRock Hill, SC | $13,306 |
| Good Samaritan Medical CenterWest Palm Beach, FL | $13,702 |
| Coastal Carolina HospitalHardeeville, SC | $13,980 |
| Marshall Medical Center SouthBoaz, AL | $14,225 |
Highest
| Peninsula Medical CenterBurlingame, CA | $26,563 |
|---|---|
| California Pacific Medical Ctr - St. Luke's CampusSan Francisco, CA | $26,563 |
| Sequoia HospitalRedwood City, CA | $26,169 |
| Stanford HospitalPalo Alto, CA | $26,169 |
| Community Hospital of the Monterey PeninsulaMonterey, CA | $26,168 |
| Washington HospitalFremont, CA | $26,168 |
| Stanford Health Care Tri-ValleyPleasanton, CA | $26,168 |
| Salinas Valley Memorial HospitalSalinas, CA | $26,168 |
| Novato Community HospitalNovato, CA | $25,953 |
| Marinhealth Medical CenterGreenbrae, CA | $25,953 |
Level 6 Musculoskeletal Procedures cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg allowed | Range |
|---|---|---|---|---|
| Alabama | 43 | $103,552 | $15,164 | $12,320 – $16,557 |
| Alaska | 5 | $297,033 | $19,345 | $18,448 – $20,115 |
| Arizona | 47 | $113,009 | $18,231 | $16,717 – $19,838 |
| Arkansas | 31 | $62,835 | $15,872 | $14,811 – $17,081 |
| California | 190 | $131,611 | $23,412 | $15,780 – $26,563 |
| Colorado | 49 | $114,583 | $17,744 | $15,058 – $18,956 |
| Connecticut | 24 | $77,329 | $20,733 | $20,002 – $20,939 |
| Delaware | 6 | $74,397 | $18,546 | $18,461 – $18,702 |
| Florida | 142 | $139,009 | $16,629 | $13,702 – $18,039 |
| Georgia | 74 | $114,576 | $16,409 | $14,155 – $17,258 |
| Hawaii | 11 | $77,314 | $21,247 | $20,418 – $22,895 |
| Idaho | 15 | $69,688 | $16,900 | $15,847 – $17,998 |
| Illinois | 85 | $94,864 | $17,391 | $15,651 – $18,403 |
| Indiana | 68 | $104,671 | $16,575 | $14,588 – $17,488 |
| Iowa | 29 | $80,535 | $16,087 | $15,502 – $17,354 |
| Kansas | 37 | $70,400 | $16,065 | $14,959 – $17,076 |
| Kentucky | 42 | $135,567 | $16,042 | $15,204 – $17,204 |
| Louisiana | 51 | $94,413 | $15,576 | $14,621 – $15,953 |
| Maine | 14 | $81,429 | $17,280 | $15,959 – $18,256 |
| Massachusetts | 45 | $52,641 | $19,887 | $18,438 – $20,967 |
| Michigan | 76 | $63,398 | $16,380 | $11,371 – $17,533 |
| Minnesota | 42 | $53,736 | $18,117 | $17,107 – $19,057 |
| Mississippi | 26 | $119,395 | $15,430 | $13,958 – $16,449 |
| Missouri | 54 | $68,370 | $16,103 | $15,295 – $17,723 |
| Montana | 10 | $58,069 | $17,606 | $16,650 – $18,495 |
| Nebraska | 23 | $60,234 | $16,771 | $16,388 – $18,049 |
| Nevada | 16 | $122,468 | $19,943 | $19,097 – $22,567 |
| New Hampshire | 12 | $99,775 | $18,184 | $17,228 – $18,994 |
| New Jersey | 50 | $99,621 | $19,847 | $18,518 – $21,153 |
| New Mexico | 18 | $99,004 | $17,126 | $15,248 – $18,610 |
| New York | 99 | $83,977 | $19,922 | $12,254 – $21,153 |
| North Carolina | 71 | $87,166 | $16,492 | $11,156 – $18,944 |
| North Dakota | 6 | $56,531 | $17,467 | $17,118 – $18,669 |
| Ohio | 108 | $78,411 | $15,978 | $6,378 – $17,433 |
| Oklahoma | 43 | $77,948 | $15,834 | $14,303 – $17,159 |
| Oregon | 30 | $72,275 | $19,883 | $17,996 – $24,168 |
| Pennsylvania | 108 | $91,576 | $17,344 | $16,034 – $19,594 |
| Rhode Island | 7 | $43,801 | $18,657 | $18,607 – $18,868 |
| South Carolina | 43 | $112,188 | $15,906 | $13,306 – $17,493 |
| South Dakota | 13 | $74,458 | $17,472 | $16,805 – $18,669 |
| Tennessee | 52 | $88,632 | $15,325 | $8,954 – $17,058 |
| Texas | 201 | $126,098 | $16,373 | $10,496 – $18,465 |
| Utah | 33 | $71,866 | $15,193 | $2,990 – $17,840 |
| Vermont | 5 | $68,568 | $8,999 | $8,448 – $12,790 |
| Virginia | 51 | $113,393 | $16,328 | $14,242 – $18,285 |
| Washington | 43 | $87,603 | $19,062 | $17,764 – $19,983 |
| West Virginia | 22 | $59,252 | $15,715 | $14,469 – $17,092 |
| Wisconsin | 58 | $68,779 | $16,885 | $15,410 – $18,084 |
| Wyoming | 9 | $64,880 | $18,154 | $17,096 – $18,669 |
Hospitals that treat the most Medicare patients for this
| Hospital | Services | Avg charge | Avg allowed |
|---|---|---|---|
| Mayo Clinic - Saint Marys HospitalRochester, MN | 393 | $59,302 | $18,974 |
| Norton Healthcare PavilionLouisville, KY | 332 | $158,552 | $15,793 |
| New England Baptist HospitalBoston, MA | 302 | $43,498 | $19,906 |
| Physicians Regional Medical Center - Pine RidgeNaples, FL | 281 | $181,329 | $16,791 |
| Eisenhower Memorial HospitalRancho Mirage, CA | 280 | $87,540 | $22,851 |
| Sioux Falls Surgical Hospital LLPSioux Falls, SD | 277 | $70,519 | $17,356 |
| Vail Valley Medical CenterVail, CO | 263 | $74,501 | $18,956 |
| Christiana Care Health Services, INC.Newark, DE | 263 | $82,909 | $18,461 |
| Hoag Orthopedic InstituteIrvine, CA | 252 | $115,075 | $22,852 |
| West Boca Medical CenterBoca Raton, FL | 235 | $143,357 | $15,486 |
| The Center for Spinal SurgeryNashville, TN | 235 | $83,403 | $15,610 |
| Iowa Methodist Medical CenterDes Moines, IA | 234 | $93,038 | $15,788 |
| Mayo Clinic HospitalPhoenix, AZ | 232 | $61,505 | $18,131 |
| Jupiter Medical CenterJupiter, FL | 227 | $83,002 | $16,781 |
| Nebraska Orthopaedic HospitalOmaha, NE | 226 | $47,735 | $16,690 |
Questions
How much does level 6 musculoskeletal procedures cost in the U.S.?
In 2024 Medicare data, level 6 musculoskeletal procedures (APC 5116) at 2,342 hospitals in the U.S. was billed at $97,523 on average, while the average medicare-allowed amount was $17,392, of which Medicare paid $15,763. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for level 6 musculoskeletal procedures?
Among states with at least three hospitals reporting, the average medicare-allowed amount was highest in California ($23,412), Hawaii ($21,247), Connecticut ($20,733) and lowest in Vermont ($8,999), Alabama ($15,164), Utah ($15,193).
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 the U.S., average charges were 5.6 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.