Outpatient procedure · APC 5115 · Surgery or procedure

Level 5 Musculoskeletal Procedures

In 2024, Medicare and patients paid an average of $12,402 per procedure at 2,213 hospitals. Half of hospitals averaged between $11,345 and $12,814.

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

National figures, 2024

Average payment per case: $12,402
Typical range (middle half of hospitals): $11,345–$12,814
Medicare’s share: $10,77287% of the payment
Average billed charge: $72,739
Hospitals reporting: 2,213362,845 procedures

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2,207 hospitals reported at least 11 Medicare procedures for this in 2024; showing 1,501–1,550. Download as CSV

Medicare payments per case for Level 5 Musculoskeletal Procedures by hospital, 2024
Hospital	Cases	Average payment	vs national average	Medicare paid	Billed charge
UCHealth Grandview HospitalColorado Springs, CO · CCN 060130	302	$12,438	About average	$10,806	$86,478
Maple Grove HospitalMaple Grove, MN · CCN 240214	182	$12,442	About average	$10,810	$32,109
Ridgeview Medical CenterWaconia, MN · CCN 240056	734	$12,443	About average	$10,811	$32,709
Marshfield Medical CenterMarshfield, WI · CCN 520037	76	$12,450	About average	$10,818	$43,622
Centura Health-Penrose St Francis Health ServicesColorado Springs, CO · CCN 060031	544	$12,450	About average	$10,818	$66,345
Concord HospitalConcord, NH · CCN 300001	398	$12,453	About average	$10,820	$51,450
Meadville Medical CenterMeadville, PA · CCN 390113	93	$12,453	About average	$10,821	$40,186
Mountainview HospitalLas Vegas, NV · CCN 290039	23	$12,456	About average	$10,818	$157,642
Park Nicollet Methodist HospitalSaint Louis Park, MN · CCN 240053	208	$12,457	About average	$10,824	$38,746
Christus Mother Frances Hospital Sulphur SpringsSulphur Springs, TX · CCN 450236	53	$12,458	About average	$10,823	$142,733
Centura Health-St Anthony North Health CampusWestminster, CO · CCN 060104	209	$12,458	About average	$10,826	$74,425
Loyola University Medical CenterMaywood, IL · CCN 140276	104	$12,459	About average	$10,825	$38,595
Wellspan Good Samaritan HospitalLebanon, PA · CCN 390066	37	$12,462	About average	$10,830	$68,031
Wentworth-Douglass HospitalDover, NH · CCN 300018	162	$12,464	About average	$10,830	$65,874
Community HospitalGrand Junction, CO · CCN 060054	237	$12,465	About average	$10,831	$53,474
The University Of Chicago Medical CenterChicago, IL · CCN 140088	213	$12,467	About average	$10,835	$95,269
Intermountain Health Cedar City HospitalCedar City, UT · CCN 460007	78	$12,468	About average	$10,835	$35,537
Allina Health Faribault Medical CenterFaribault, MN · CCN 240071	11	$12,468	About average	$10,836	$45,648
Owatonna HospitalOwatonna, MN · CCN 240069	46	$12,468	About average	$10,834	$43,297
University Of Illinois Hospital And ClinicsChicago, IL · CCN 140150 · +$984 outlier payments per case	36	$12,471	About average	$10,839	$72,355
St Lukes HospitalBethlehem, PA · CCN 390049	372	$12,473	About average	$10,843	$90,665
Animas Surgical Hospital, LLCDurango, CO · CCN 060117	318	$12,476	About average	$10,844	$61,554
Advocate Illinois Masonic Medical CenterChicago, IL · CCN 140182	73	$12,477	About average	$10,845	$77,209
Franciscan Health Olympia & Chicago HeightsOlympia Fields, IL · CCN 140172	47	$12,477	About average	$10,845	$79,272
Saint Joseph Medical CenterJoliet, IL · CCN 140007	37	$12,477	About average	$10,845	$84,947
Mercyhealth Hospital & Physician Clinic-Crystal LaCrystal Lake, IL · CCN 140308	12	$12,477	About average	$10,845	$71,371
Swedish HospitalChicago, IL · CCN 140114	12	$12,477	About average	$10,845	$69,549
Uchicago Medicine AdventHealth HinsdaleHinsdale, IL · CCN 140122	12	$12,477	About average	$10,845	$75,402
Northfield HospitalNorthfield, MN · CCN 240014	134	$12,480	About average	$10,848	$46,249
M Health Fairview Ridges HospitalBurnsville, MN · CCN 240207	108	$12,481	About average	$10,848	$38,747
John T Mather Memorial Hospital Of Port JeffersonPort Jefferson, NY · CCN 330185	218	$12,483	About average	$10,850	$52,181
AdventHealth PorterDenver, CO · CCN 060064 · +$58 outlier payments per case	430	$12,485	About average	$10,852	$72,364
Presence Mercy Medical CenterAurora, IL · CCN 140174	32	$12,487	About average	$10,848	$112,588
Banner Desert Medical CenterMesa, AZ · CCN 030065	99	$12,493	About average	$10,867	$79,245
Hunterdon Medical CenterFlemington, NJ · CCN 310005	84	$12,494	About average	$10,928	$43,333
Presbyterian Espanola HospitalEspanola, NM · CCN 320011	41	$12,495	About average	$10,863	$37,643
M Health Fairview Woodwinds HospitalWoodbury, MN · CCN 240213	351	$12,501	About average	$10,869	$36,468
St Joseph Regional Medical CenterLewiston, ID · CCN 130003	136	$12,504	About average	$10,871	$71,311
Northern Light Maine Coast HospitalEllsworth, ME · CCN 200050	26	$12,505	About average	$10,873	$62,996
Sentara Halifax Regional HospitalSouth Boston, VA · CCN 490013	11	$12,506	About average	$10,874	$53,278
Catholic Medical CenterManchester, NH · CCN 300034	104	$12,510	About average	$10,876	$70,413
Parkview Medical Center, IncPueblo, CO · CCN 060020	190	$12,510	About average	$10,878	$133,727
St Francis Hospital - InterquestColorado Springs, CO · CCN 060133	111	$12,510	About average	$10,878	$62,465
Centura Health-St Anthony HospitalLakewood, CO · CCN 060015	16	$12,510	About average	$10,878	$86,486
Denver Health & Hospital AuthorityDenver, CO · CCN 060011	19	$12,510	About average	$10,878	$48,335
HCA Healthone Presbyterian St. LukesDenver, CO · CCN 060014	23	$12,510	About average	$10,878	$215,298
Intermountain Health Lutheran HospitalWheat Ridge, CO · CCN 060009	34	$12,510	About average	$10,878	$80,734
Intermountain Health Platte Valley HospitalBrighton, CO · CCN 060004	68	$12,510	About average	$10,878	$55,546
Longmont United HospitalLongmont, CO · CCN 060003	59	$12,510	About average	$10,878	$65,854
AdventHealth AvistaLouisville, CO · CCN 060103	74	$12,510	About average	$10,878	$82,411

National trend

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

Average payment
Average billed charge

2020: 229,215 procedures at 2,037 hospitals · 2021: 364,363 procedures at 2,254 hospitals · 2022: 410,561 procedures at 2,321 hospitals · 2023: 427,124 procedures at 2,312 hospitals · 2024: 362,845 procedures at 2,213 hospitals

View data as a table

National average payment and billed charge for Level 5 Musculoskeletal Procedures
Year of care	Average payment	Average billed charge
2020	$12K	$61K
2021	$12K	$66K
2022	$12K	$68K
2023	$13K	$71K
2024	$12K	$73K

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 5 Musculoskeletal Procedures, 2024
State	Hospitals	Cases	Average payment	Typical range
Vermont	6	927	$6,642	$5,710–$7,857
Alabama	36	5,517	$10,733	$10,538–$10,928
Mississippi	25	1,977	$10,843	$10,672–$11,006
Tennessee	47	8,201	$10,865	$10,654–$11,195
Louisiana	44	5,417	$10,909	$10,733–$11,044
West Virginia	19	2,033	$11,015	$10,538–$11,114
Ohio	104	15,215	$11,123	$11,029–$11,497
Oklahoma	42	7,005	$11,159	$11,026–$11,326
Arkansas	28	5,195	$11,206	$11,043–$11,679
South Carolina	43	9,015	$11,244	$11,083–$11,366
Kentucky	42	5,097	$11,263	$10,995–$11,552
Kansas	34	6,049	$11,345	$11,166–$11,885
Iowa	29	5,825	$11,405	$11,208–$11,925
Missouri	53	8,629	$11,419	$11,333–$11,837
Virginia	55	13,156	$11,531	$11,183–$12,118
Michigan	73	8,557	$11,535	$11,319–$11,944
Texas	188	27,220	$11,614	$11,350–$11,866
Georgia	71	9,007	$11,645	$11,145–$12,011
North Carolina	65	11,812	$11,652	$11,347–$11,739
New Mexico	16	2,050	$11,704	$11,270–$12,005
Utah	32	3,863	$11,712	$11,479–$11,775
Indiana	64	9,630	$11,754	$11,642–$11,909
Nebraska	21	4,927	$11,799	$11,652–$12,128
Florida	133	23,438	$11,799	$11,730–$11,906
Idaho	15	2,954	$11,894	$11,784–$12,386
Wisconsin	56	7,721	$11,921	$11,695–$12,134
Maine	14	1,590	$12,045	$11,422–$12,212
Pennsylvania	105	17,854	$12,207	$11,693–$12,571
Montana	10	2,257	$12,302	$12,157–$12,991
Illinois	82	14,943	$12,334	$12,119–$12,518
South Dakota	13	3,867	$12,387	$12,258–$13,048
North Dakota	6	1,935	$12,448	$12,260–$12,787
Colorado	47	8,262	$12,564	$12,388–$12,511
New Hampshire	11	2,199	$12,713	$12,410–$12,672
Minnesota	42	6,532	$12,735	$12,361–$12,965
Arizona	47	9,066	$12,802	$12,653–$12,814
Wyoming	10	919	$12,806	$12,962–$13,194
Delaware	6	2,342	$13,085	$13,029–$13,172
District of Columbia	4	774	$13,274	$13,278–$13,444
Rhode Island	8	825	$13,278	$13,310–$13,335
Washington	43	7,875	$13,453	$13,133–$13,721
Alaska	6	992	$13,858	$13,747–$14,483
Oregon	29	3,599	$13,939	$13,452–$13,786
Nevada	16	2,147	$13,956	$13,488–$13,899
Massachusetts	43	9,382	$13,997	$13,872–$14,027
New Jersey	43	10,137	$14,069	$13,614–$14,536
New York	91	13,630	$14,226	$13,725–$14,676
Connecticut	23	3,597	$14,579	$14,481–$14,714
Hawaii	9	682	$14,923	$14,484–$15,494
California	164	27,002	$16,486	$15,996–$16,675

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.