Level 6 Musculoskeletal Procedures in North Carolina
What 71 hospitals in North Carolina charged and were paid for level 6 musculoskeletal procedures (APC 5116), from 2024 Medicare claims.
Average charge
$87,166
Hospital list price billed
Average allowed
$16,492
Medicare's payment + patient's share
Medicare paid
$14,869
Average per service
State rank
#20 of 49
1 = lowest average payment
Hospitals in North Carolina billed an average of $87,166 for level 6 musculoskeletal procedures, about 5.3 times the average medicare-allowed amount of $16,492. That payment is 5% 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 $16,492Billed $87,166
About 19¢ was paid for every $1 hospitals in North Carolina billed for this service.
North Carolina hospitals: level 6 musculoskeletal procedures
Every North Carolina 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 Hanover Regional Medical CenterWilmington | 188 | $87,508 | $17,164 | $15,532 |
| Moses H Cone Memorial Hospital, theGreensboro | 181 | $80,595 | $16,682 | $15,050 |
| Carolinas Medical Center/Behav HealthCharlotte | 176 | $117,791 | $16,540 | $14,905 |
| Duke University Medical CenterDurham | 167 | $99,812 | $16,593 | $14,961 |
| Margaret R Pardee Mem HospitalHendersonville | 161 | $59,882 | $16,043 | $14,416 |
| Rex HospitalRaleigh | 111 | $87,393 | $16,606 | $14,974 |
| Memorial Mission Hospital and Asheville Surgery CeAsheville | 103 | $132,859 | $16,184 | $14,550 |
| Duke Health Raleigh HospitalRaleigh | 102 | $68,200 | $16,594 | $14,962 |
| Duke Regional HospitalDurham | 93 | $83,489 | $16,774 | $15,142 |
| North Carolina Eye & Ear HospDurham | 87 | $62,422 | $16,281 | $14,647 |
| Firsthealth Moore Regional HospitalPinehurst | 86 | $49,838 | $16,491 | $14,859 |
| Forsyth Memorial HospitalWinston-Salem | 80 | $78,347 | $16,950 | $15,318 |
| ECU Health Medical CenterGreenville | 76 | $59,041 | $15,801 | $14,167 |
| Atrium Health PinevilleCharlotte | 64 | $105,110 | $16,710 | $15,078 |
| Wakemed, Raleigh CampusRaleigh | 63 | $116,309 | $16,525 | $14,889 |
| Carolina East Medical CenterNew Bern | 59 | $73,481 | $17,331 | $15,699 |
| Carolinas Medical Center-NortheastConcord | 54 | $122,516 | $16,710 | $15,078 |
| North Carolina Baptist HospitalWinston-Salem | 54 | $125,720 | $16,667 | $15,035 |
| UNC HospitalsChapel Hill | 50 | $55,951 | $16,981 | $15,349 |
| Caromont Regional Medical CenterGastonia | 48 | $90,126 | $16,396 | $14,762 |
| Adventhealth HendersonvilleFletcher | 43 | $122,115 | $16,184 | $14,552 |
| Watauga Medical CenterBoone | 43 | $63,839 | $17,331 | $15,699 |
| Carteret General HospitalMorehead City | 42 | $33,190 | $11,156 | $10,107 |
| Presbyterian Hospital HuntersvilleHuntersville | 40 | $104,980 | $15,956 | $14,324 |
| Wayne Memorial HospitalGoldsboro | 38 | $45,950 | $18,944 | $17,312 |
| Wakemed, Cary HospitalCary | 37 | $89,072 | $16,334 | $14,702 |
| High Point Regional Hlth SystHigh Point | 31 | $136,410 | $16,044 | $14,412 |
| Johnston Memorial HospitalSmithfield | 27 | $66,658 | $16,236 | $14,639 |
| Haywood Regional Medical CenterClyde | 26 | $77,213 | $16,184 | $14,543 |
| Presbyterian HospitalCharlotte | 25 | $98,390 | $16,710 | $15,078 |
| C J Harris Community HospitalSylva | 24 | $94,170 | $16,184 | $14,552 |
| Lake Norman Regional Medical CenterMooresville | 24 | $118,127 | $15,454 | $13,822 |
| Cape Fear Valley Medical CenterFayetteville | 20 | $68,373 | $16,445 | $14,813 |
| Lexington Memorial Hospital INCLexington | 19 | $86,200 | $16,144 | $14,512 |
| Brunswick Community HospitalSupply | 19 | $117,919 | $16,184 | $14,552 |
| Presbyterian Hospital-MatthewsMatthews | 19 | $110,267 | $15,917 | $14,285 |
| Alamance Regional Medical CenterBurlington | 18 | $70,282 | $16,981 | $15,349 |
| Cleveland Regional Medical CenterShelby | 17 | $100,823 | $16,536 | $14,904 |
| Albemarle Hospital AuthorityElizabeth City | 16 | $60,163 | $17,331 | $15,699 |
| Catawba Valley Medical CenterHickory | 16 | $57,604 | $16,408 | $14,776 |
| Davie Medical CenterBermuda Run | 14 | $117,468 | $15,856 | $14,224 |
| Carolinas Medical Center-UnionMonroe | 13 | $98,157 | $16,710 | $15,078 |
| Caldwell Memorial HospitalLenoir | 12 | $53,522 | $16,184 | $14,552 |
| Rowan Regional Medical CenterSalisbury | 11 | $98,230 | $16,710 | $15,078 |
| Cape Fear Valley Hoke HospitalRaeford | 11 | $62,213 | $16,184 | $14,552 |
| Northern Hospital of Surry CountyMt Airy | – | – | – | – |
| Scotland Memorial HospitalLaurinburg | – | – | – | – |
| Rutherford Hospital INCRutherfordton | – | – | – | – |
| Sampson Regional Medical CenterClinton | – | – | – | – |
| Iredell Memorial Hospital INCStatesville | – | – | – | – |
| Onslow Memorial HospitalJacksonville | – | – | – | – |
| Southeastern Regional Medical CenterLumberton | – | – | – | – |
| UNC RockinghamEden | – | – | – | – |
| Columbus Regional Healthcare SystemWhiteville | – | – | – | – |
| Betsy Johnson Regional HospitalDunn | – | – | – | – |
| Grace Hospital INCMorganton | – | – | – | – |
| Hugh Chatham Memorial HospitalElkin | – | – | – | – |
| Roanoke Chowan HospitalAhoskie | – | – | – | – |
| Vidant Edgecombe HospitalTarboro | – | – | – | – |
| Frye Regional Medical CenterHickory | – | – | – | – |
| Stanly Regional Medical CenterAlbemarle | – | – | – | – |
| Randolph HospitalAsheboro | – | – | – | – |
| Wilson Medical CenterWilson | – | – | – | – |
| Granville Medical CenterOxford | – | – | – | – |
| Maria Parham HospitalHenderson | – | – | – | – |
| Carolinas Medical Center-LincolnLincolnton | – | – | – | – |
| Nash General HospitalRocky Mount | – | – | – | – |
| ECU Health North HospitalRoanoke Rapids | – | – | – | – |
| Carolinas Med Ctr-UniversityCharlotte | – | – | – | – |
| Novant Health Mint Hill Medical CenterCharlotte | – | – | – | – |
| Novant Health Ballantyne Medical CenterCharlotte | – | – | – | – |
Lowest and highest allowed amounts in North Carolina
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
| Carteret General HospitalMorehead City, NC | $11,156 |
|---|---|
| Lake Norman Regional Medical CenterMooresville, NC | $15,454 |
| ECU Health Medical CenterGreenville, NC | $15,801 |
| Davie Medical CenterBermuda Run, NC | $15,856 |
| Presbyterian Hospital-MatthewsMatthews, NC | $15,917 |
Highest
| Wayne Memorial HospitalGoldsboro, NC | $18,944 |
|---|---|
| Watauga Medical CenterBoone, NC | $17,331 |
| Albemarle Hospital AuthorityElizabeth City, NC | $17,331 |
| Carolina East Medical CenterNew Bern, NC | $17,331 |
| New Hanover Regional Medical CenterWilmington, NC | $17,164 |
Level 6 Musculoskeletal Procedures in other states
Questions
How much does level 6 musculoskeletal procedures cost in North Carolina?
In 2024 Medicare data, level 6 musculoskeletal procedures (APC 5116) at 71 hospitals in North Carolina was billed at $87,166 on average, while the average medicare-allowed amount was $16,492, of which Medicare paid $14,869. 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 North Carolina, average charges were 5.3 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.