Level 6 Musculoskeletal Procedures in West Virginia
What 22 hospitals in West Virginia charged and were paid for level 6 musculoskeletal procedures (APC 5116), from 2024 Medicare claims.
Average charge
$59,252
Hospital list price billed
Average allowed
$15,715
Medicare's payment + patient's share
Medicare paid
$14,082
Average per service
State rank
#7 of 49
1 = lowest average payment
Hospitals in West Virginia billed an average of $59,252 for level 6 musculoskeletal procedures, about 3.8 times the average medicare-allowed amount of $15,715. That payment is 10% 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 $15,715Billed $59,252
About 27¢ was paid for every $1 hospitals in West Virginia billed for this service.
West Virginia hospitals: level 6 musculoskeletal procedures
Every West 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 |
|---|---|---|---|---|
| Thomas Memorial HospitalSouth Charleston | 164 | $42,166 | $15,680 | $14,048 |
| Saint Francis HospitalCharleston | 81 | $55,714 | $15,418 | $13,780 |
| United Hospital CenterBridgeport | 72 | $62,197 | $17,092 | $15,458 |
| St Mary's Medical CenterHuntington | 48 | $69,793 | $15,547 | $13,915 |
| Cabell-Huntington Hospital INCHuntington | 41 | $81,072 | $15,843 | $14,211 |
| Camden Clark Memorial HospitalParkersburg | 36 | $54,127 | $15,374 | $13,742 |
| West Virginia University HospitalsMorgantown | 27 | $79,729 | $15,045 | $13,413 |
| Camc Charleston Surgical HospitalCharleston | 22 | $37,798 | $15,124 | $13,481 |
| Berkeley Medical CenterMartinsburg | 21 | $72,894 | $17,075 | $15,443 |
| Reynolds Memorial HospitalGlen Dale | 21 | $63,712 | $14,551 | $12,919 |
| Charleston Area Medical CenterCharleston | 14 | $116,501 | $14,757 | $13,119 |
| Mon Health Medical CenterMorgantown | 11 | $95,410 | $14,469 | $12,837 |
| Greenbrier Valley Medical CenterRonceverte | – | – | – | – |
| Rivers HealthPoint Pleasant | – | – | – | – |
| Weirton Medical CenterWeirton | – | – | – | – |
| Davis Memorial HospitalElkins | – | – | – | – |
| Stonewall Jackson Mem HospWeston | – | – | – | – |
| Princeton Community HospitalPrinceton | – | – | – | – |
| Wheeling HospitalWheeling | – | – | – | – |
| Beckley Arh HospitalBeckley | – | – | – | – |
| Raleigh General HospitalBeckley | – | – | – | – |
| Wetzel County HospitalNew Martinsville | – | – | – | – |
Lowest and highest allowed amounts in West 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
| Mon Health Medical CenterMorgantown, WV | $14,469 |
|---|---|
| Reynolds Memorial HospitalGlen Dale, WV | $14,551 |
| Charleston Area Medical CenterCharleston, WV | $14,757 |
| West Virginia University HospitalsMorgantown, WV | $15,045 |
| Camc Charleston Surgical HospitalCharleston, WV | $15,124 |
Highest
| United Hospital CenterBridgeport, WV | $17,092 |
|---|---|
| Berkeley Medical CenterMartinsburg, WV | $17,075 |
| Cabell-Huntington Hospital INCHuntington, WV | $15,843 |
| Thomas Memorial HospitalSouth Charleston, WV | $15,680 |
| St Mary's Medical CenterHuntington, WV | $15,547 |
Level 6 Musculoskeletal Procedures in other states
Questions
How much does level 6 musculoskeletal procedures cost in West Virginia?
In 2024 Medicare data, level 6 musculoskeletal procedures (APC 5116) at 22 hospitals in West Virginia was billed at $59,252 on average, while the average medicare-allowed amount was $15,715, of which Medicare paid $14,082. 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 West Virginia, average charges were 3.8 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.