Level 6 Musculoskeletal Procedures in Wisconsin
What 58 hospitals in Wisconsin charged and were paid for level 6 musculoskeletal procedures (APC 5116), from 2024 Medicare claims.
Average charge
$68,779
Hospital list price billed
Average allowed
$16,885
Medicare's payment + patient's share
Medicare paid
$15,253
Average per service
State rank
#24 of 49
1 = lowest average payment
Hospitals in Wisconsin billed an average of $68,779 for level 6 musculoskeletal procedures, about 4.1 times the average medicare-allowed amount of $16,885. That payment is 3% 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 $16,885Billed $68,779
About 25¢ was paid for every $1 hospitals in Wisconsin billed for this service.
Wisconsin hospitals: level 6 musculoskeletal procedures
Every Wisconsin 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 Wi Hospitals & Clinics AuthorityMadison | 164 | $83,917 | $17,359 | $15,723 |
| Appleton Med CtrAppleton | 84 | $32,733 | $16,403 | $14,768 |
| Sauk Prairie Mem HsptlPrairie du Sac | 75 | $40,996 | $16,751 | $15,119 |
| Gundersen Luth Med CtrLa Crosse | 67 | $77,990 | $17,073 | $15,455 |
| Midwest Orthopedic Specialty Hospital, LLCFranklin | 65 | $74,956 | $16,234 | $14,599 |
| St Mary's HospitalMadison | 64 | $63,901 | $17,359 | $15,727 |
| Aspirus Wausau HospitalWausau | 55 | $61,986 | $16,367 | $14,735 |
| Oakleaf Surgical HospitalEau Claire | 54 | $49,559 | $16,714 | $15,082 |
| Oconomowoc Mem HsptlOconomowoc | 51 | $93,487 | $16,941 | $15,309 |
| Luther Hospital Mayo Health SystemEau Claire | 48 | $49,715 | $17,641 | $16,009 |
| Aurora Baycare Med CtrGreen Bay | 43 | $66,443 | $16,744 | $15,112 |
| Bellin Memorial HsptlGreen Bay | 42 | $75,402 | $16,283 | $14,651 |
| Community Mem HsptlMenomonee Falls | 41 | $78,102 | $16,194 | $14,562 |
| Aurora St Lukes Medical CenterMilwaukee | 40 | $100,945 | $16,565 | $14,933 |
| Aurora Med Ctr KenoshaKenosha | 38 | $78,137 | $17,050 | $15,418 |
| Aurora Medical CenterSummit | 31 | $57,038 | $16,956 | $15,324 |
| Aurora Medical CenterGrafton | 31 | $86,083 | $16,941 | $15,309 |
| Fort HealthcareFort Atkinson | 27 | $44,002 | $16,941 | $15,309 |
| Froedtert SouthKenosha | 26 | $73,201 | $17,488 | $15,856 |
| Meriter HsptlMadison | 26 | $94,170 | $17,359 | $15,727 |
| Mayo Clinic Health System-Franciscan Medical CenterLa Crosse | 25 | $58,336 | $17,518 | $15,886 |
| Marshfield Medical Center - Eau ClaireEau Claire | 25 | $52,187 | $16,714 | $15,082 |
| St Marys Hsptl Med CtrGreen Bay | 24 | $59,659 | $16,725 | $15,093 |
| Aurora Sheboygan Mem Med CtrSheboygan | 20 | $65,205 | $16,137 | $14,505 |
| Ascension SE Wisconsin HospitalMilwaukee | 19 | $64,484 | $16,941 | $15,309 |
| Aurora Med Ctr OshkoshOshkosh | 19 | $54,539 | $16,744 | $15,111 |
| Orthopaedic Hsptl of WiGlendale | 18 | $67,268 | $16,941 | $15,309 |
| Ministry St Michaels Hospital of Stevens PointStevens Point | 17 | $52,027 | $16,640 | $15,008 |
| Froedtert Mem Lutheran HsptlMilwaukee | 17 | $91,046 | $16,564 | $14,932 |
| Beloit Mem HsptlBeloit | 15 | $107,544 | $18,084 | $16,452 |
| Aspirus Rhinelander HospitalRhinelander | 13 | $45,934 | $17,819 | $16,187 |
| Aurora Med Ctr Manitowoc CtyTwo Rivers | 13 | $63,762 | $16,667 | $15,035 |
| Mercy Hlth Sys CorpJanesville | 13 | $76,377 | $16,941 | $15,309 |
| Marshfield Medical Center - Rice LakeRice Lake | 12 | $55,900 | $17,819 | $16,187 |
| UW Hlth Partners - Watertown Regional Medical CtrWatertown | 12 | $80,618 | $16,941 | $15,309 |
| Aurora West Allis Medical CenterWest Allis | 12 | $94,466 | $15,410 | $13,778 |
| Waukesha Memorial HospitalWaukesha | 11 | $168,331 | $16,941 | $15,309 |
| Holy Family Memorial INCManitowoc | 11 | $73,480 | $16,725 | $15,093 |
| St Elizabeth HsptlAppleton | – | – | – | – |
| Monroe ClinicMonroe | – | – | – | – |
| Aspirus Riverview Hospital & ClinicsWisconsin Rapids | – | – | – | – |
| Aurora Med Center-Washington CountyHartford | – | – | – | – |
| Divine Savior HlthcarePortage | – | – | – | – |
| St Nicholas HospitalSheboygan | – | – | – | – |
| Thedacare Regional Med Ctr - NeenahNeenah | – | – | – | – |
| Columbia St Marys Hsptl Milw (Col & Milw Campus)Milwaukee | – | – | – | – |
| St Clare Hsptl Hlth SvcsBaraboo | – | – | – | – |
| Aurora Memorial Hsptl BurlingtonBurlington | – | – | – | – |
| St Josephs Com Hsptl West BendWest Bend | – | – | – | – |
| St Vincent HsptlGreen Bay | – | – | – | – |
| Beaver Dam Com HsptlBeaver Dam | – | – | – | – |
| St Agnes HsptlFond du Lac | – | – | – | – |
| Wheaton Franciscan Healthcare- All SaintsRacine | – | – | – | – |
| Aurora Lakeland Med CtrElkhorn | – | – | – | – |
| Mile Bluff Medical Center, INCMauston | – | – | – | – |
| Bay Area Med CtrMarinette | – | – | – | – |
| St Clare's Hospital of Weston INCWeston | – | – | – | – |
| SSM Health St Mary's Hospital - JanesvilleJanesville | – | – | – | – |
Lowest and highest allowed amounts in Wisconsin
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
| Aurora West Allis Medical CenterWest Allis, WI | $15,410 |
|---|---|
| Aurora Sheboygan Mem Med CtrSheboygan, WI | $16,137 |
| Community Mem HsptlMenomonee Falls, WI | $16,194 |
| Midwest Orthopedic Specialty Hospital, LLCFranklin, WI | $16,234 |
| Bellin Memorial HsptlGreen Bay, WI | $16,283 |
Highest
| Beloit Mem HsptlBeloit, WI | $18,084 |
|---|---|
| Marshfield Medical Center - Rice LakeRice Lake, WI | $17,819 |
| Aspirus Rhinelander HospitalRhinelander, WI | $17,819 |
| Luther Hospital Mayo Health SystemEau Claire, WI | $17,641 |
| Mayo Clinic Health System-Franciscan Medical CenterLa Crosse, WI | $17,518 |
Level 6 Musculoskeletal Procedures in other states
Questions
How much does level 6 musculoskeletal procedures cost in Wisconsin?
In 2024 Medicare data, level 6 musculoskeletal procedures (APC 5116) at 58 hospitals in Wisconsin was billed at $68,779 on average, while the average medicare-allowed amount was $16,885, of which Medicare paid $15,253. 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 Wisconsin, average charges were 4.1 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.