facebook tracking Level 6 Musculoskeletal Procedures cost in North Dakota: 6 hospitals compared (APC 5116)

Level 6 Musculoskeletal Procedures in North Dakota

What 6 hospitals in North Dakota charged and were paid for level 6 musculoskeletal procedures (APC 5116), from 2024 Medicare claims.

APC 5116 Outpatient 2024 Medicare data
Average charge $56,531 Hospital list price billed
Average allowed $17,467 Medicare's payment + patient's share
Medicare paid $15,834 Average per service
State rank #30 of 49 1 = lowest average payment

Hospitals in North Dakota billed an average of $56,531 for level 6 musculoskeletal procedures, about 3.2 times the average medicare-allowed amount of $17,467. That payment is about the same as 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 $17,467Billed $56,531

About 31¢ was paid for every $1 hospitals in North Dakota billed for this service.

North Dakota hospitals: level 6 musculoskeletal procedures

Every North Dakota hospital that billed Medicare for this service at least 11 times. Click a column to sort.

Hospital Services Avg charge Avg allowed Medicare paid
St Alexius Medical CenterBismarck 119 $55,865 $17,168 $15,536
Sanford Medical Center FargoFargo 112 $53,689 $17,434 $15,801
Sanford Medical Center BismarckBismarck 106 $59,339 $17,434 $15,800
Essentia Health-FargoFargo 50 $48,964 $17,118 $15,486
Altru Health SystemGrand Forks 34 $75,088 $18,669 $17,037
Trinity HospitalsMinot 16 $46,985 $18,669 $17,037
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Lowest and highest allowed amounts in North Dakota

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

Essentia Health-FargoFargo, ND$17,118
St Alexius Medical CenterBismarck, ND$17,168
Sanford Medical Center FargoFargo, ND$17,434
Sanford Medical Center BismarckBismarck, ND$17,434
Trinity HospitalsMinot, ND$18,669

Highest

Trinity HospitalsMinot, ND$18,669
Altru Health SystemGrand Forks, ND$18,669
Sanford Medical Center BismarckBismarck, ND$17,434
Sanford Medical Center FargoFargo, ND$17,434
St Alexius Medical CenterBismarck, ND$17,168

Level 6 Musculoskeletal Procedures in other states

Questions

How much does level 6 musculoskeletal procedures cost in North Dakota?

In 2024 Medicare data, level 6 musculoskeletal procedures (APC 5116) at 6 hospitals in North Dakota was billed at $56,531 on average, while the average medicare-allowed amount was $17,467, of which Medicare paid $15,834. 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 Dakota, average charges were 3.2 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.