Level 6 Musculoskeletal Procedures in Kentucky
What 42 hospitals in Kentucky charged and were paid for level 6 musculoskeletal procedures (APC 5116), from 2024 Medicare claims.
Average charge
$135,567
Hospital list price billed
Average allowed
$16,042
Medicare's payment + patient's share
Medicare paid
$14,409
Average per service
State rank
#12 of 49
1 = lowest average payment
Hospitals in Kentucky billed an average of $135,567 for level 6 musculoskeletal procedures, about 8.5 times the average medicare-allowed amount of $16,042. That payment is 8% below the U.S. average 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 $16,042Billed $135,567
About 12¢ was paid for every $1 hospitals in Kentucky billed for this service.
Kentucky hospitals: level 6 musculoskeletal procedures
Every Kentucky hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Norton Healthcare PavilionLouisville | 332 | $158,552 | $15,793 | $14,162 |
| Baptist Hospital EastLouisville | 222 | $144,297 | $15,829 | $14,196 |
| Central Baptist HospitalLexington | 140 | $189,626 | $15,899 | $14,264 |
| Western Baptist HospitalPaducah | 111 | $218,013 | $17,013 | $15,378 |
| St Elizabeth FlorenceFlorence | 89 | $62,793 | $16,010 | $14,378 |
| Greenview Regional HospitalBowling Green | 66 | $97,202 | $16,068 | $14,436 |
| Lourdes HospitalPaducah | 63 | $71,358 | $16,769 | $15,131 |
| Hardin Memorial HospitalElizabethtown | 53 | $141,973 | $15,752 | $14,120 |
| Owensboro Medical Health SystemOwensboro | 45 | $123,310 | $17,204 | $15,572 |
| Jewish HospitalLouisville | 44 | $100,595 | $15,696 | $14,064 |
| Saint Joseph HospitalLexington | 39 | $48,129 | $15,738 | $14,106 |
| University of Kentucky HospLexington | 38 | $66,891 | $15,725 | $14,090 |
| Saint Joseph LondonLondon | 30 | $45,651 | $15,604 | $13,971 |
| Jennie Stuart Medical CenterHopkinsville | 25 | $52,897 | $16,709 | $15,077 |
| Baptist Hospital NortheastLa Grange | 20 | $163,330 | $16,023 | $14,391 |
| Baptist Health Deaconess MadisonvilleMadisonville | 18 | $204,580 | $17,204 | $15,572 |
| Georgetown Community HospitalGeorgetown | 15 | $133,280 | $15,204 | $13,572 |
| Murray-Calloway County HospitalMurray | 13 | $56,929 | $15,604 | $13,972 |
| Lake Cumberland Regional HospitalSomerset | 13 | $175,769 | $15,948 | $14,316 |
| T J Samson Community HospitalGlasgow | 12 | $51,541 | $15,772 | $14,140 |
| King's Daughters' Medical CenterAshland | 11 | $66,346 | $15,843 | $14,211 |
| Clark Regional Medical CenterWinchester | 11 | $118,011 | $16,106 | $14,474 |
| St Elizabeth Ft ThomasFort Thomas | – | – | – | – |
| Muhlenberg Community HospitalGreenville | – | – | – | – |
| Highlands Regional Medical CenterPrestonsburg | – | – | – | – |
| The Medical Center at Bowling GreenBowling Green | – | – | – | – |
| Jewish Hospital - ShelbyvilleShelbyville | – | – | – | – |
| St Claire Regional Medical CenterMorehead | – | – | – | – |
| Meadowview Regional Medical CenterMaysville | – | – | – | – |
| Spring View HospitalLebanon | – | – | – | – |
| Flaget Memorial HospitalBardstown | – | – | – | – |
| St Elizabeth Med Center-SouthEdgewood | – | – | – | – |
| Memorial HospitalManchester | – | – | – | – |
| Pikeville Medical CenterPikeville | – | – | – | – |
| Ephraim McDowell Regional Medical CenterDanville | – | – | – | – |
| Baptist Health RichmondRichmond | – | – | – | – |
| Deaconess Henderson HospitalHenderson | – | – | – | – |
| Saint Joseph Mount SterlingMt Sterling | – | – | – | – |
| Taylor Regional HospitalCampbellsville | – | – | – | – |
| Jackson Purchase Medical CenterMayfield | – | – | – | – |
| University of Louisville HospitalLouisville | – | – | – | – |
| Saint Joseph EastLexington | – | – | – | – |
Lowest and highest allowed amounts in Kentucky
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
| Georgetown Community HospitalGeorgetown, KY | $15,204 |
|---|---|
| Murray-Calloway County HospitalMurray, KY | $15,604 |
| Saint Joseph LondonLondon, KY | $15,604 |
| Jewish HospitalLouisville, KY | $15,696 |
| University of Kentucky HospLexington, KY | $15,725 |
Highest
| Owensboro Medical Health SystemOwensboro, KY | $17,204 |
|---|---|
| Baptist Health Deaconess MadisonvilleMadisonville, KY | $17,204 |
| Western Baptist HospitalPaducah, KY | $17,013 |
| Lourdes HospitalPaducah, KY | $16,769 |
| Jennie Stuart Medical CenterHopkinsville, KY | $16,709 |
Level 6 Musculoskeletal Procedures in other states
Questions
How much does level 6 musculoskeletal procedures cost in Kentucky?
In 2024 Medicare data, level 6 musculoskeletal procedures (APC 5116) at 42 hospitals in Kentucky was billed at $135,567 on average, while the average medicare-allowed amount was $16,042, of which Medicare paid $14,409. 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 Kentucky, average charges were 8.5 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.