Level 6 Musculoskeletal Procedures in Virginia
What 51 hospitals in Virginia charged and were paid for level 6 musculoskeletal procedures (APC 5116), from 2024 Medicare claims.
Average charge
$113,393
Hospital list price billed
Average allowed
$16,328
Medicare's payment + patient's share
Medicare paid
$14,700
Average per service
State rank
#16 of 49
1 = lowest average payment
Hospitals in Virginia billed an average of $113,393 for level 6 musculoskeletal procedures, about 6.9 times the average medicare-allowed amount of $16,328. That payment is 6% 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 $16,328Billed $113,393
About 14¢ was paid for every $1 hospitals in Virginia billed for this service.
Virginia hospitals: level 6 musculoskeletal procedures
Every Virginia hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| University of Virginia Medical CenterCharlottesville | 202 | $70,858 | $14,242 | $12,672 |
| Sentara Leigh HospitalNorfolk | 199 | $55,155 | $15,963 | $14,330 |
| Carilion Medical CenterRoanoke | 142 | $103,246 | $15,606 | $13,971 |
| Inova Mount Vernon HospitalAlexandria | 122 | $53,736 | $17,178 | $15,546 |
| Mary Immaculate HospitalNewport News | 111 | $132,535 | $15,754 | $14,122 |
| Inova Fair Oaks HospitalFairfax | 106 | $58,307 | $17,288 | $15,656 |
| Inova Alexandria HospitalAlexandria | 104 | $68,812 | $17,437 | $15,805 |
| Sentara Bayside HospitalVirginia Beach | 100 | $62,096 | $15,896 | $14,263 |
| Cjw Medical CenterRichmond | 98 | $462,582 | $16,011 | $14,379 |
| Henrico Doctors' HospitalRichmond | 89 | $411,745 | $15,984 | $14,351 |
| Sentara Careplex HospitalHampton | 84 | $55,868 | $16,182 | $14,550 |
| Reston Hospital CenterReston | 74 | $165,966 | $17,432 | $15,797 |
| Centra Health - Lynchburg Gen HospitalLynchburg | 65 | $97,441 | $16,907 | $15,272 |
| Bon Secours - Memorial Regional MedicalMechanicsville | 65 | $108,085 | $16,837 | $15,205 |
| Winchester Medical Center INCWinchester | 64 | $52,964 | $18,024 | $16,389 |
| Augusta HealthFishersville | 49 | $103,156 | $17,973 | $16,341 |
| Inova Fairfax HospitalFalls Church | 49 | $76,547 | $16,792 | $15,160 |
| Mary Washington Hospital, INCFredericksburg | 48 | $52,729 | $17,437 | $15,805 |
| Lewisgale Medical CenterSalem | 48 | $243,738 | $16,011 | $14,374 |
| Bon Secours - St Marys Hospital of RichmondRichmond | 46 | $139,161 | $16,403 | $14,767 |
| Virginia Hospital Center - ArlingtonArlington | 45 | $87,424 | $17,437 | $15,805 |
| Stafford Hospital CenterStafford | 43 | $51,266 | $17,069 | $15,437 |
| Bon Secours - St Francis Medical CenterMidlothian | 42 | $125,407 | $15,836 | $14,201 |
| Sentara Obici HospitalSuffolk | 40 | $59,463 | $15,658 | $14,021 |
| Martha Jefferson HospitalCharlottesville | 38 | $45,632 | $15,787 | $14,154 |
| Sentara Northern Virginia Medical CenterWoodbridge | 38 | $55,366 | $17,021 | $15,389 |
| Riverside Doctors' Hospital of WilliamsburgWilliamsburg | 37 | $48,871 | $16,013 | $14,381 |
| Sentara Rmh Medical CenterHarrisonburg | 34 | $52,729 | $18,285 | $16,653 |
| UVA Health Haymarket Medical CenterHaymarket | 32 | $89,192 | $17,583 | $15,951 |
| Sentara Williamsburg Regional Medical CenterWilliamsburg | 31 | $52,704 | $16,013 | $14,381 |
| Sentara Virginia Beach General HospitalVirginia Beach | 30 | $63,539 | $15,212 | $13,580 |
| Medical College of Virginia HospitalsRichmond | 29 | $84,597 | $15,049 | $13,405 |
| Bon Secours - Maryview Medical CenterPortsmouth | 21 | $119,501 | $14,643 | $13,011 |
| Culpeper Regional HospitalCulpeper | 20 | $103,283 | $17,437 | $15,805 |
| Montgomery Regional HospitalBlacksburg | 18 | $324,192 | $16,032 | $14,400 |
| Riverside Regional Medical CenterNewport News | 15 | $63,916 | $16,013 | $14,381 |
| Chesapeake General HospitalChesapeake | 13 | $117,766 | $16,182 | $14,550 |
| Riverside Walter Reed HospitalGloucester | 13 | $66,097 | $16,013 | $14,381 |
| Warren Memorial HospitalFront Royal | 12 | $45,890 | $17,437 | $15,805 |
| Inova Loudoun HospitalLeesburg | 12 | $84,812 | $17,437 | $15,805 |
| John Randolph Medical CenterHopewell | 11 | $478,676 | $16,182 | $14,550 |
| Sentara Norfolk General HospitalNorfolk | – | – | – | – |
| The Fauquier Hospital, INCWarrenton | – | – | – | – |
| Smyth County Community HospitalMarion | – | – | – | – |
| Carilion New River Vly Med CtrChristiansburg | – | – | – | – |
| Johnston Memorial HospitalAbingdon | – | – | – | – |
| Danville Regional Medical CenterDanville | – | – | – | – |
| Riverside Tappahannock HospitalTappahannock | – | – | – | – |
| Twin County Regional HospitalGalax | – | – | – | – |
| Spotsylvania Regional Medical CenterFredericksburg | – | – | – | – |
| Stonesprings Hospital CenterDulles | – | – | – | – |
Lowest and highest allowed amounts in Virginia
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
| University of Virginia Medical CenterCharlottesville, VA | $14,242 |
|---|---|
| Bon Secours - Maryview Medical CenterPortsmouth, VA | $14,643 |
| Medical College of Virginia HospitalsRichmond, VA | $15,049 |
| Sentara Virginia Beach General HospitalVirginia Beach, VA | $15,212 |
| Carilion Medical CenterRoanoke, VA | $15,606 |
Highest
| Sentara Rmh Medical CenterHarrisonburg, VA | $18,285 |
|---|---|
| Winchester Medical Center INCWinchester, VA | $18,024 |
| Augusta HealthFishersville, VA | $17,973 |
| UVA Health Haymarket Medical CenterHaymarket, VA | $17,583 |
| Culpeper Regional HospitalCulpeper, VA | $17,437 |
Level 6 Musculoskeletal Procedures in other states
Questions
How much does level 6 musculoskeletal procedures cost in Virginia?
In 2024 Medicare data, level 6 musculoskeletal procedures (APC 5116) at 51 hospitals in Virginia was billed at $113,393 on average, while the average medicare-allowed amount was $16,328, of which Medicare paid $14,700. 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 Virginia, average charges were 6.9 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.