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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 Rhode Island

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
Rhode Island
Specific hospitals up to 10
Average payment across these 7 hospitals
$7,123National $6,708 · Rhode Island $7,123
Median hospital
$7,260
Lowest to highest
$6,719–$7,260
Medicare procedures
391

7 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
Newport HospitalNewport, RI · CCN 41000675$6,719About average$5,319$14,691
Kent County Memorial HospitalWarwick, RI · CCN 41000965$7,171About average$5,696$17,544
Rhode Island HospitalProvidence, RI · CCN 410007149$7,212About average$5,744$14,602
The Miriam HospitalProvidence, RI · CCN 41001235$7,260About average$5,785$15,184
South County Hospital IncWakefield, RI · CCN 41000833$7,260About average$5,784$18,927
Our Lady Of Fatima HospitalNorth Providence, RI · CCN 41000515$7,260About average$5,783$17,354
Roger Williams Medical CenterProvidence, RI · CCN 41000419$7,260About average$5,781$17,655

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.