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Outpatient procedure · APC 5114 · Surgery or procedure

Level 4 Musculoskeletal Procedures

In 2024, Medicare and patients paid an average of $6,708 per procedure at 2,236 hospitals. Half of hospitals averaged between $6,160 and $6,976.

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

National figures, 2024

Average payment per case
$6,708
Typical range (middle half of hospitals)
$6,160–$6,976
Medicare’s share
$5,33980% of the payment
Average billed charge
$46,846
Hospitals reporting
2,236166,476 procedures

Hospitals in Maine

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
Maine
Specific hospitals up to 10
Average payment across these 13 hospitals
$6,469National $6,708 · Maine $6,469
Median hospital
$6,574
Lowest to highest
$5,863–$6,823
Medicare procedures
897

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

Medicare payments per case for Level 4 Musculoskeletal Procedures by hospital, 2024
HospitalCasesAverage paymentvs national averageMedicare paidBilled charge
Northern Light Inland HospitalWaterville, ME · CCN 20004113$5,86313% below the national average$4,591$33,396
Northern Light Eastern Maine Medical CenterBangor, ME · CCN 200033129$6,079About average$4,809$25,999
St Mary's Regional Medical CenterLewiston, ME · CCN 200034 · +$880 outlier payments per case42$6,094About average$4,822$47,454
St Joseph HospitalBangor, ME · CCN 200001 · +$514 outlier payments per case78$6,139About average$4,891$30,212
Northern Light A R Gould HospitalPresque Isle, ME · CCN 20001815$6,139About average$4,891$46,090
Southern Maine Health CareBiddeford, ME · CCN 20001929$6,168About average$4,799$33,849
Mainehealth Pen Bay HospitalRockport, ME · CCN 20006319$6,574About average$5,238$32,660
York HospitalYork, ME · CCN 20002039$6,584About average$5,218$30,546
Central Maine Medical CenterLewiston, ME · CCN 200024 · +$2,781 outlier payments per case34$6,612About average$5,263$28,245
Mainehealth Maine Medical CenterPortland, ME · CCN 200009 · +$309 outlier payments per case207$6,618About average$5,252$30,610
Northern Light Mercy HospitalPortland, ME · CCN 200008 · +$363 outlier payments per case154$6,652About average$5,286$27,429
Mainehealth Mid Coast HospitalBrunswick, ME · CCN 200021 · +$916 outlier payments per case55$6,722About average$5,354$34,541
Maine General Medical CenterAugusta, ME · CCN 200039 · +$484 outlier payments per case83$6,823About average$5,392$34,734

National trend

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

  • Average payment
  • Average billed charge
2020: 185,926 procedures at 2,416 hospitals · 2021: 195,670 procedures at 2,445 hospitals · 2022: 186,999 procedures at 2,389 hospitals · 2023: 171,396 procedures at 2,317 hospitals · 2024: 166,476 procedures at 2,236 hospitals
View data as a table
National average payment and billed charge for Level 4 Musculoskeletal Procedures
Year of careAverage paymentAverage billed charge
2020$5,850$36K
2021$6,173$38K
2022$6,265$41K
2023$6,439$43K
2024$6,708$47K

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 4 Musculoskeletal Procedures, 2024
StateHospitalsCasesAverage paymentTypical range
Vermont6406$3,797$3,255–$3,916
Alabama403,199$5,780$5,631–$5,969
Mississippi271,649$5,823$5,775–$5,941
Tennessee513,601$5,874$5,762–$6,061
Louisiana442,934$5,934$5,870–$6,009
South Carolina424,711$5,959$5,941–$6,150
West Virginia191,042$6,000$5,847–$6,062
Oklahoma474,231$6,079$5,978–$6,242
Ohio976,480$6,094$6,004–$6,255
Kentucky382,604$6,103$5,904–$6,196
Arkansas273,228$6,128$5,995–$6,357
Kansas373,194$6,178$6,076–$6,414
Missouri544,429$6,179$6,129–$6,357
Michigan733,919$6,197$6,092–$6,411
Iowa261,799$6,231$6,040–$6,446
Georgia734,396$6,231$6,047–$6,499
Texas18814,876$6,317$6,207–$6,467
Virginia564,434$6,335$6,122–$6,565
North Carolina655,586$6,354$6,226–$6,437
Indiana654,325$6,361$6,324–$6,467
Utah311,792$6,374$6,159–$6,409
Florida13110,094$6,397$6,364–$6,480
Nebraska231,952$6,401$6,280–$6,540
New Mexico17768$6,455$6,082–$6,447
Maine13897$6,469$6,139–$6,618
Idaho151,643$6,476$6,438–$6,749
Wisconsin543,455$6,482$6,373–$6,665
Pennsylvania1057,105$6,566$6,340–$6,811
Illinois835,712$6,652$6,540–$6,792
South Dakota131,994$6,722$6,636–$7,053
Montana9943$6,754$6,664–$7,044
North Dakota6913$6,773$6,707–$6,936
Colorado463,137$6,822$6,747–$6,810
New Hampshire12886$6,863$6,697–$6,917
Minnesota412,455$6,909$6,681–$6,908
Wyoming10395$6,970$6,897–$7,183
Arizona463,573$7,012$6,879–$6,976
Rhode Island7391$7,123$7,191–$7,260
Delaware6568$7,128$7,114–$7,167
District of Columbia4325$7,212$7,161–$7,276
Washington433,552$7,247$7,117–$7,445
Nevada181,135$7,592$7,431–$7,662
New Jersey503,791$7,592$7,398–$7,661
Massachusetts495,761$7,605$7,565–$7,683
Oregon291,729$7,605$7,289–$7,507
Alaska6341$7,642$7,412–$7,862
New York936,933$7,713$7,585–$8,061
Connecticut211,133$7,916$7,863–$8,026
Hawaii10419$8,172$8,004–$8,526
California17011,641$9,047$8,737–$9,368

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.