Level 6 Musculoskeletal Procedures in Massachusetts
What 45 hospitals in Massachusetts charged and were paid for level 6 musculoskeletal procedures (APC 5116), from 2024 Medicare claims.
Average charge
$52,641
Hospital list price billed
Average allowed
$19,887
Medicare's payment + patient's share
Medicare paid
$18,254
Average per service
State rank
#44 of 49
1 = lowest average payment
Hospitals in Massachusetts billed an average of $52,641 for level 6 musculoskeletal procedures, about 2.6 times the average medicare-allowed amount of $19,887. That payment is 14% above 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 $19,887Billed $52,641
About 38¢ was paid for every $1 hospitals in Massachusetts billed for this service.
Massachusetts hospitals: level 6 musculoskeletal procedures
Every Massachusetts hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| New England Baptist HospitalBoston | 302 | $43,498 | $19,906 | $18,273 |
| Massachusetts General HospitalBoston | 194 | $79,590 | $19,966 | $18,334 |
| Baystate Medical CenterSpringfield | 153 | $44,193 | $19,846 | $18,212 |
| Newton-Wellesley HospitalNewton Lower Falls | 103 | $56,287 | $19,966 | $18,328 |
| Cape Cod HospitalHyannis | 81 | $31,993 | $19,966 | $18,334 |
| South Shore HospitalSouth Weymouth | 74 | $36,936 | $19,718 | $18,086 |
| Faulkner HospitalBoston | 67 | $55,549 | $19,966 | $18,334 |
| Umass Memorial Medical Center INCWorcester | 56 | $99,418 | $19,966 | $18,329 |
| Beverly Hospital CorporationBeverly | 49 | $33,427 | $19,966 | $18,332 |
| Emerson HospitalConcord | 45 | $35,682 | $19,966 | $18,333 |
| Union HospitalLynn | 44 | $53,861 | $19,966 | $18,328 |
| Lahey Clinic HospitalBurlington | 41 | $31,825 | $19,966 | $18,334 |
| Mount Auburn HospitalCambridge | 40 | $31,690 | $19,966 | $18,334 |
| Milford Regional Medical CenterMilford | 40 | $38,549 | $19,966 | $18,334 |
| Beth Israel Deaconess Hospital PlymouthPlymouth | 38 | $52,634 | $19,966 | $18,334 |
| Southcoast Hospital Group, INCFall River | 34 | $80,454 | $19,966 | $18,334 |
| Brigham and Women's HosptialBoston | 33 | $74,537 | $19,410 | $17,778 |
| Tufts Medical CenterBoston | 29 | $52,054 | $19,333 | $17,701 |
| Sturdy Memorial HospitalAttleboro | 26 | $52,860 | $19,966 | $18,334 |
| Beth Israel Deaconess Medical CenterBoston | 25 | $34,821 | $19,966 | $18,334 |
| Lawrence General HospitalLawrence | 24 | $42,766 | $19,966 | $18,334 |
| Winchester HospitalWinchester | 23 | $40,313 | $19,966 | $18,334 |
| Lowell General HospitalLowell | 22 | $35,227 | $19,966 | $18,334 |
| Falmouth HospitalFalmouth | 22 | $44,504 | $19,132 | $17,500 |
| Holy Family Hospital, a Caritas Family HospitalMethuen | 20 | $57,927 | $19,966 | $18,334 |
| Noble HospitalWestfield | 18 | $39,202 | $19,966 | $18,334 |
| Mercy Medical CenterSpringfield | 17 | $49,512 | $19,966 | $18,334 |
| Melrosewakefield HealthcareMelrose | 17 | $42,911 | $19,966 | $18,334 |
| Cooley Dickinson Hospital Inc,TheNorthampton | 14 | $44,318 | $19,966 | $18,334 |
| Healthalliance Hospitals, INCLeominster | 13 | $105,437 | $19,966 | $18,334 |
| Boston Medical Center CorporationBoston | 12 | $54,575 | $18,438 | $16,806 |
| Berkshire Medical Center INCPittsfield | 12 | $85,868 | $20,967 | $19,335 |
| Marlborough HospitalMarlborough | 12 | $99,437 | $18,438 | $16,806 |
| St Vincent HospitalWorcester | 11 | $147,997 | $19,966 | $18,334 |
| Cambridge Health AllianceCambridge | – | – | – | – |
| Baystate Franklin Medical CenterGreenfield | – | – | – | – |
| Carney HospitalDorchester | – | – | – | – |
| Harrington Memorial HospitalSouthbridge | – | – | – | – |
| Saint Anne's Hospital, a Caritas Family HospitalFall River | – | – | – | – |
| Holyoke Medical CenterHolyoke | – | – | – | – |
| Anna Jaques HospitalNewburyport | – | – | – | – |
| Morton Hospital & Medical CenterTaunton | – | – | – | – |
| Heywood HospitalGardner | – | – | – | – |
| Good Samaritan Medical Center, a Caritas Family HoBrockton | – | – | – | – |
| Metrowest Medical CenterFramingham | – | – | – | – |
Lowest and highest allowed amounts in Massachusetts
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
| Boston Medical Center CorporationBoston, MA | $18,438 |
|---|---|
| Marlborough HospitalMarlborough, MA | $18,438 |
| Falmouth HospitalFalmouth, MA | $19,132 |
| Tufts Medical CenterBoston, MA | $19,333 |
| Brigham and Women's HosptialBoston, MA | $19,410 |
Highest
| Berkshire Medical Center INCPittsfield, MA | $20,967 |
|---|---|
| Newton-Wellesley HospitalNewton Lower Falls, MA | $19,966 |
| Union HospitalLynn, MA | $19,966 |
| Umass Memorial Medical Center INCWorcester, MA | $19,966 |
| Beverly Hospital CorporationBeverly, MA | $19,966 |
Level 6 Musculoskeletal Procedures in other states
Questions
How much does level 6 musculoskeletal procedures cost in Massachusetts?
In 2024 Medicare data, level 6 musculoskeletal procedures (APC 5116) at 45 hospitals in Massachusetts was billed at $52,641 on average, while the average medicare-allowed amount was $19,887, of which Medicare paid $18,254. 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 Massachusetts, average charges were 2.6 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.