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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

Hospitals in Montana

Narrow by a state, city or ZIP code (optionally a distance around it), and/or pick specific hospitals. With both, your picks are added to the area’s hospitals.

Location
Montana
Specific hospitals up to 10
Average payment across these 9 hospitals
$3,003National $2,995 · Montana $3,003
Median hospital
$3,035
Lowest to highest
$2,884–$3,250
Medicare procedures
456

9 hospitals reported at least 11 Medicare procedures for this in 2024. Download as CSV

Medicare payments per case for Level 3 Musculoskeletal Procedures by hospital, 2024
HospitalCasesAverage paymentvs national averageMedicare paidBilled charge
Billings Clinic HospitalBillings, MT · CCN 270004162$2,884About average$2,287$5,443
Benefis Hospitals IncGreat Falls, MT · CCN 27001245$2,927About average$2,310$14,569
Intermountain Health St Vincent Regional HospitalBillings, MT · CCN 27004929$2,951About average$2,335$15,486
Great Falls Clinic HospitalGreat Falls, MT · CCN 27008678$3,004About average$2,382$23,223
Community Medical CenterMissoula, MT · CCN 27002320$3,035About average$2,418$24,695
St. Patrick HospitalMissoula, MT · CCN 27001425$3,035About average$2,412$12,671
St Peters HealthHelena, MT · CCN 27000316$3,187About average$2,539$9,615
Bozeman Health Deaconess HospitalBozeman, MT · CCN 27005743$3,250About average$2,589$16,815
Logan Health Medical CenterKalispell, MT · CCN 27005138$3,250About average$2,582$11,537

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 careAverage paymentAverage 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
StateHospitalsCasesAverage paymentTypical range
Vermont6413$1,583$1,314–$1,899
Mississippi28947$2,519$2,601–$2,686
Alabama391,853$2,552$2,533–$2,680
Tennessee492,127$2,620$2,638–$2,781
Louisiana391,910$2,668$2,629–$2,719
West Virginia20804$2,683$2,599–$2,724
South Carolina422,831$2,688$2,716–$2,802
Ohio984,734$2,715$2,702–$2,815
Georgia622,484$2,723$2,699–$2,930
Kentucky371,726$2,727$2,706–$2,851
Oklahoma473,250$2,735$2,692–$2,841
Arkansas272,136$2,751$2,707–$2,897
Kansas321,981$2,754$2,752–$2,852
Missouri532,474$2,773$2,722–$2,915
Michigan722,772$2,779$2,722–$2,890
Iowa251,094$2,782$2,708–$2,900
Nebraska191,210$2,813$2,834–$2,917
Texas1749,030$2,828$2,772–$2,922
North Carolina652,991$2,846$2,785–$2,890
Virginia542,605$2,856$2,778–$3,032
Indiana562,731$2,859$2,854–$2,950
Idaho14939$2,879$2,864–$3,061
Utah301,037$2,882$2,835–$2,900
Florida1115,022$2,883$2,871–$2,932
New Mexico17564$2,895$2,752–$2,910
Maine14591$2,895$2,738–$2,941
Pennsylvania985,031$2,901$2,844–$3,083
Wisconsin542,612$2,921$2,872–$2,995
Illinois813,523$2,967$2,919–$3,073
Minnesota431,776$2,975$2,937–$3,094
Montana9456$3,003$2,951–$3,187
South Dakota131,592$3,054$3,014–$3,211
North Dakota6723$3,059$3,035–$3,078
Colorado431,532$3,070$3,025–$3,081
New Hampshire12560$3,114$3,084–$3,162
Arizona442,123$3,136$3,072–$3,156
Wyoming10243$3,183$3,156–$3,250
Delaware6415$3,203$3,186–$3,238
District of Columbia4160$3,234$3,218–$3,312
Rhode Island7372$3,249$3,230–$3,285
Washington411,980$3,260$3,204–$3,335
Nevada16646$3,395$3,325–$3,399
New Jersey482,146$3,401$3,341–$3,505
Massachusetts484,090$3,414$3,413–$3,476
Alaska6236$3,415$3,300–$3,453
Oregon301,006$3,424$3,273–$3,396
New York944,940$3,442$3,389–$3,647
Connecticut25750$3,562$3,515–$3,611
Hawaii5168$3,666$3,617–$3,899
California1506,667$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.