Outpatient procedure · APC 5113 · Surgery or procedure

Level 3 Musculoskeletal Procedures

In 2024, Medicare and patients paid an average of $2,995 per procedure at 2,123 hospitals. Half of hospitals averaged between $2,769 and $3,147.

Also known as: Orthopedic surgery, arthroscopy, outpatient joint surgery

National figures, 2024

Average payment per case: $2,995
Typical range (middle half of hospitals): $2,769–$3,147
Medicare’s share: $2,37379% of the payment
Average billed charge: $23,965
Hospitals reporting: 2,123104,003 procedures

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2,119 hospitals reported at least 11 Medicare procedures for this in 2024; showing 2,051–2,100. Download as CSV

Medicare payments per case for Level 3 Musculoskeletal Procedures by hospital, 2024
Hospital	Cases	Average payment	vs national average	Medicare paid	Billed charge
Providence St. Jude Medical CenterFullerton, CA · CCN 050168	67	$3,980	33% above the national average	$3,168	$17,693
Providence St Joseph HospitalEureka, CA · CCN 050006	69	$3,980	33% above the national average	$3,167	$40,203
Grossmont HospitalLa Mesa, CA · CCN 050026	65	$3,980	33% above the national average	$3,167	$31,596
Santa Monica - UCLA Medical Center & Orthopaedic HospitalSanta Monica, CA · CCN 050112	54	$3,980	33% above the national average	$3,166	$21,796
Mad River Community HospitalArcata, CA · CCN 050028	35	$3,980	33% above the national average	$3,166	$19,028
Pioneers Memorial Healthcare DistrictBrawley, CA · CCN 050342	32	$3,980	33% above the national average	$3,165	$14,586
French Hospital Medical CenterSan Luis Obispo, CA · CCN 050232	34	$3,980	33% above the national average	$3,164	$33,857
Scripps Memorial Hospital - EncinitasEncinitas, CA · CCN 050503	25	$3,980	33% above the national average	$3,163	$61,698
PIH Health Hospital-WhittierWhittier, CA · CCN 050169	50	$3,980	33% above the national average	$3,163	$24,033
Adventist Health Twin CitiesTempleton, CA · CCN 050633	12	$3,980	33% above the national average	$3,158	$54,517
Providence Little Company Of Mary Medical Center TorranceTorrance, CA · CCN 050353	27	$3,980	33% above the national average	$3,157	$28,188
Lac/Olive View-UCLA Medical CenterSylmar, CA · CCN 050040	13	$3,980	33% above the national average	$3,156	$27,394
Adventist Health White MemorialLos Angeles, CA · CCN 050103	23	$3,980	33% above the national average	$3,154	$57,170
Uci Health - Placentia LindaPlacentia, CA · CCN 050589	21	$3,980	33% above the national average	$3,153	$64,989
Glendale Adventist Medical CenterGlendale, CA · CCN 050239	19	$3,980	33% above the national average	$3,151	$49,028
Hilo Benioff Medical CenterHilo, HI · CCN 120005	11	$3,987	33% above the national average	$3,177	$17,151
Sutter Surgical Hospital - North ValleyYuba City, CA · CCN 050766 · +$1,028 outlier payments per case	53	$4,004	34% above the national average	$3,189	$23,625
Barton Memorial HospitalSouth Lake Tahoe, CA · CCN 050352	64	$4,050	35% above the national average	$3,214	$46,102
Dameron HospitalStockton, CA · CCN 050122	31	$4,065	36% above the national average	$3,239	$42,001
Adventist Health Lodi MemorialLodi, CA · CCN 050336	19	$4,065	36% above the national average	$3,239	$48,325
Sutter Tracy Community HospitalTracy, CA · CCN 050313	15	$4,065	36% above the national average	$3,239	$24,392
Stanislaus Surgical HospitalModesto, CA · CCN 050726	23	$4,066	36% above the national average	$3,240	$25,376
Emanuel Medical CenterTurlock, CA · CCN 050179	31	$4,067	36% above the national average	$3,231	$91,113
Sutter Roseville Medical CenterRoseville, CA · CCN 050309	265	$4,072	36% above the national average	$3,229	$21,441
Marshall Medical CenterPlacerville, CA · CCN 050254	66	$4,084	36% above the national average	$3,241	$45,998
Sky Lakes Medical CenterKlamath Falls, OR · CCN 380050	87	$4,093	37% above the national average	$3,238	$12,131
Mercy Hospital Of FolsomFolsom, CA · CCN 050414	38	$4,134	38% above the national average	$3,294	$50,434
Mercy San Juan Medical CenterCarmichael, CA · CCN 050516	12	$4,134	38% above the national average	$3,294	$44,208
Sutter Davis HospitalDavis, CA · CCN 050537	30	$4,134	38% above the national average	$3,294	$25,569
Sierra Nevada Memorial HospitalGrass Valley, CA · CCN 050150	22	$4,134	38% above the national average	$3,291	$28,180
Adventist Health St HelenaSaint Helena, CA · CCN 050013	30	$4,154	39% above the national average	$3,310	$82,625
St Joseph's Medical Center Of StocktonStockton, CA · CCN 050084	13	$4,172	39% above the national average	$3,269	$60,284
Adventist Health SonoraSonora, CA · CCN 050335	77	$4,174	39% above the national average	$3,308	$43,922
Adventist Health Ukiah ValleyUkiah, CA · CCN 050301	22	$4,262	42% above the national average	$3,396	$30,260
St Elizabeth Community HospitalRed Bluff, CA · CCN 050042	15	$4,262	42% above the national average	$3,396	$48,173
Adventist Health And RideoutMarysville, CA · CCN 050133	28	$4,262	42% above the national average	$3,395	$36,119
Santa Barbara Cottage HospitalSanta Barbara, CA · CCN 050396	16	$4,263	42% above the national average	$3,372	$20,623
Sutter Maternity & Surgery Center Of Santa CruzSanta Cruz, CA · CCN 050714	70	$4,278	43% above the national average	$3,396	$25,877
Natividad Medical CenterSalinas, CA · CCN 050248	13	$4,305	44% above the national average	$3,430	$28,247
Regional Medical Center Of San JoseSan Jose, CA · CCN 050125	15	$4,316	44% above the national average	$3,389	$78,386
Sonoma Valley HospitalSonoma, CA · CCN 050090	24	$4,321	44% above the national average	$3,442	$45,973
Sutter Santa Rosa Regional HospitalSanta Rosa, CA · CCN 050291	33	$4,321	44% above the national average	$3,442	$29,071
Petaluma Valley HospitalPetaluma, CA · CCN 050136	28	$4,321	44% above the national average	$3,426	$30,716
Watsonville Community HospitalWatsonville, CA · CCN 050194	16	$4,325	44% above the national average	$3,446	$41,108
Alta Bates Summit Medical Center - Alta Bates CampBerkeley, CA · CCN 050305	17	$4,336	45% above the national average	$3,421	$28,650
Stanford Health CareStanford, CA · CCN 050441 · +$436 outlier payments per case	393	$4,370	46% above the national average	$3,473	$66,869
Providence Santa Rosa Memorial HospitalSanta Rosa, CA · CCN 050174	51	$4,389	47% above the national average	$3,480	$50,417
California Pacific Medical Center-Davies Campus HospitalSan Francisco, CA · CCN 050008	76	$4,398	47% above the national average	$3,488	$24,177
Sutter Solano Medical CenterVallejo, CA · CCN 050101	15	$4,410	47% above the national average	$3,451	$22,959
MarinHealth Medical CenterGreenbrae, CA · CCN 050360	34	$4,415	47% above the national average	$3,490	$65,011

National trend

Average payment and billed charge per procedure, and how many Medicare procedures were reported each year.

Average payment
Average billed charge

2020: 125,574 procedures at 2,351 hospitals · 2021: 206,449 procedures at 2,335 hospitals · 2022: 117,912 procedures at 2,259 hospitals · 2023: 113,399 procedures at 2,189 hospitals · 2024: 104,003 procedures at 2,123 hospitals

View data as a table

National average payment and billed charge for Level 3 Musculoskeletal Procedures
Year of care	Average payment	Average billed charge
2020	$2,660	$19K
2021	$1,684	$12K
2022	$2,815	$21K
2023	$2,870	$22K
2024	$2,995	$24K

By state, 2024

Case-weighted average payment across each state’s reporting hospitals, lowest first.

Show all 50 states

Average payment by state for Level 3 Musculoskeletal Procedures, 2024
State	Hospitals	Cases	Average payment	Typical range
Vermont	6	413	$1,583	$1,314–$1,899
Mississippi	28	947	$2,519	$2,601–$2,686
Alabama	39	1,853	$2,552	$2,533–$2,680
Tennessee	49	2,127	$2,620	$2,638–$2,781
Louisiana	39	1,910	$2,668	$2,629–$2,719
West Virginia	20	804	$2,683	$2,599–$2,724
South Carolina	42	2,831	$2,688	$2,716–$2,802
Ohio	98	4,734	$2,715	$2,702–$2,815
Georgia	62	2,484	$2,723	$2,699–$2,930
Kentucky	37	1,726	$2,727	$2,706–$2,851
Oklahoma	47	3,250	$2,735	$2,692–$2,841
Arkansas	27	2,136	$2,751	$2,707–$2,897
Kansas	32	1,981	$2,754	$2,752–$2,852
Missouri	53	2,474	$2,773	$2,722–$2,915
Michigan	72	2,772	$2,779	$2,722–$2,890
Iowa	25	1,094	$2,782	$2,708–$2,900
Nebraska	19	1,210	$2,813	$2,834–$2,917
Texas	174	9,030	$2,828	$2,772–$2,922
North Carolina	65	2,991	$2,846	$2,785–$2,890
Virginia	54	2,605	$2,856	$2,778–$3,032
Indiana	56	2,731	$2,859	$2,854–$2,950
Idaho	14	939	$2,879	$2,864–$3,061
Utah	30	1,037	$2,882	$2,835–$2,900
Florida	111	5,022	$2,883	$2,871–$2,932
New Mexico	17	564	$2,895	$2,752–$2,910
Maine	14	591	$2,895	$2,738–$2,941
Pennsylvania	98	5,031	$2,901	$2,844–$3,083
Wisconsin	54	2,612	$2,921	$2,872–$2,995
Illinois	81	3,523	$2,967	$2,919–$3,073
Minnesota	43	1,776	$2,975	$2,937–$3,094
Montana	9	456	$3,003	$2,951–$3,187
South Dakota	13	1,592	$3,054	$3,014–$3,211
North Dakota	6	723	$3,059	$3,035–$3,078
Colorado	43	1,532	$3,070	$3,025–$3,081
New Hampshire	12	560	$3,114	$3,084–$3,162
Arizona	44	2,123	$3,136	$3,072–$3,156
Wyoming	10	243	$3,183	$3,156–$3,250
Delaware	6	415	$3,203	$3,186–$3,238
District of Columbia	4	160	$3,234	$3,218–$3,312
Rhode Island	7	372	$3,249	$3,230–$3,285
Washington	41	1,980	$3,260	$3,204–$3,335
Nevada	16	646	$3,395	$3,325–$3,399
New Jersey	48	2,146	$3,401	$3,341–$3,505
Massachusetts	48	4,090	$3,414	$3,413–$3,476
Alaska	6	236	$3,415	$3,300–$3,453
Oregon	30	1,006	$3,424	$3,273–$3,396
New York	94	4,940	$3,442	$3,389–$3,647
Connecticut	25	750	$3,562	$3,515–$3,611
Hawaii	5	168	$3,666	$3,617–$3,899
California	150	6,667	$4,064	$3,960–$4,167

About these numbers

Average payment is what Medicare paid plus the patient’s deductible and coinsurance (and any other insurer), averaged over the hospital’s Medicare cases. It covers the hospital’s part of the care; doctors bill separately. For outpatient procedures it is Medicare’s allowed amount, which leaves out extra “outlier” payments for unusually costly cases; those are shown under the hospital name where CMS reported any, and included in the CSV. Billed charges are the hospital’s list prices, which few patients pay.

Medicare sets its payments by formula, adjusting for local wages, teaching programs, the share of low-income patients and unusually costly cases. Those adjustments drive most differences between hospitals, so a lower payment doesn’t mean better or worse care, and Medicare patients’ own costs usually vary much less than the totals. Private insurance pays different, usually higher, prices.

Source: CMS Medicare Outpatient Hospitals by Provider and Service (Medicare fee-for-service claims). CMS omits hospitals with fewer than 11 procedures. More in the glossary.