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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Year of care

2,207 hospitals reported at least 11 Medicare procedures for this in 2024; showing 1,551–1,600. 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
AdventHealth ParkerParker, CO · CCN 060114	116	$12,510	About average	$10,876	$75,976
UCHealth Broomfield HospitalBroomfield, CO · CCN 060129	76	$12,510	About average	$10,875	$88,306
Banner North Co Medical Center - Loveland CampusLoveland, CO · CCN 060030	46	$12,511	About average	$10,871	$72,850
Multicare Auburn Medical CenterAuburn, WA · CCN 500015	52	$12,512	About average	$10,880	$83,657
Saint Alphonsus Regional Medical CenterBoise, ID · CCN 130007	326	$12,516	About average	$10,883	$38,646
Banner Thunderbird Medical CenterGlendale, AZ · CCN 030089	151	$12,518	About average	$10,883	$62,520
Beloit Health SystemBeloit, WI · CCN 520100	86	$12,522	About average	$10,890	$86,455
Hannibal Regional HospitalHannibal, MO · CCN 260025	134	$12,526	About average	$10,892	$84,168
Presence Saint Joseph Hospital - ChicagoChicago, IL · CCN 140224	44	$12,528	About average	$10,890	$86,682
Banner Estrella Medical CenterPhoenix, AZ · CCN 030115	80	$12,535	About average	$10,903	$68,329
Doylestown HospitalDoylestown, PA · CCN 390203	159	$12,540	About average	$10,905	$50,223
St Joseph's HospitalTucson, AZ · CCN 030011 · +$424 outlier payments per case	82	$12,541	About average	$10,909	$215,438
St. George Regional HospitalSt George, UT · CCN 460021	511	$12,544	About average	$10,910	$37,003
Loyola Gottlieb Memorial HospitalMelrose Park, IL · CCN 140008	94	$12,546	About average	$10,909	$39,542
Lehigh Valley Hospital - PoconoEast Stroudsburg, PA · CCN 390201	42	$12,551	About average	$10,919	$71,570
Augusta HealthFishersville, VA · CCN 490018 · +$37 outlier payments per case	539	$12,558	About average	$10,926	$79,526
Banner North Colorado Medical CenterGreeley, CO · CCN 060001	85	$12,559	About average	$10,925	$68,641
Fairview Northland Regional HospitalPrinceton, MN · CCN 240141	31	$12,562	About average	$10,930	$51,132
Regions HospitalSaint Paul, MN · CCN 240106	43	$12,562	About average	$10,930	$39,848
Buffalo HospitalBuffalo, MN · CCN 240076	47	$12,562	About average	$10,930	$43,268
Hennepin County Medical CenterMinneapolis, MN · CCN 240004	16	$12,562	About average	$10,930	$49,152
North Memorial Health HospitalRobbinsdale, MN · CCN 240001	34	$12,562	About average	$10,924	$36,497
Southern NH Medical CenterNashua, NH · CCN 300020	125	$12,564	About average	$10,932	$71,908
MercyOne North Iowa Medical CenterMason City, IA · CCN 160064	193	$12,565	About average	$10,932	$57,621
St Luke's Hospital - Grand View CampusSellersville, PA · CCN 390057	293	$12,569	About average	$10,937	$35,434
HonorHealth Four Peaks Medical CenterMesa, AZ · CCN 030121	77	$12,569	About average	$10,937	$88,490
Great Plains HealthNorth Platte, NE · CCN 280065	219	$12,570	About average	$10,944	$59,637
Penn Highlands DuboisDubois, PA · CCN 390086	56	$12,571	About average	$10,939	$34,199
UPMC SomersetSomerset, PA · CCN 390039	23	$12,571	About average	$10,939	$42,988
Conemaugh Memorial Medical CenterJohnstown, PA · CCN 390110	33	$12,571	About average	$10,931	$66,197
Sentara RMH Medical CenterHarrisonburg, VA · CCN 490004	165	$12,581	About average	$10,948	$36,196
HonorHealth Scottsdale Osborn Medical CenterScottsdale, AZ · CCN 030038	290	$12,583	About average	$10,951	$114,779
HonorHealth Tempe Medical CenterPhoenix, AZ · CCN 030037	90	$12,583	About average	$10,946	$74,364
Winchester Medical CenterWinchester, VA · CCN 490005	267	$12,584	About average	$10,952	$34,167
Aspirus Rhinelander HospitalRhinelander, WI · CCN 520019	59	$12,594	About average	$10,962	$44,539
Mile Bluff Medical CenterMauston, WI · CCN 520109	31	$12,594	About average	$10,962	$45,421
San Juan Regional Medical Center IncFarmington, NM · CCN 320005	179	$12,597	About average	$10,967	$38,524
Flagler HospitalSaint Augustine, FL · CCN 100090	360	$12,603	About average	$10,968	$49,099
The Core Institute Specialty HospitalPhoenix, AZ · CCN 030108	826	$12,603	About average	$10,971	$75,994
Chester County HospitalWest Chester, PA · CCN 390179	305	$12,605	About average	$10,973	$47,387
Intermountain Health Sevier Valley HospitalRichfield, UT · CCN 460026	65	$12,608	About average	$10,976	$41,960
Wayne Memorial HospitalHonesdale, PA · CCN 390125	22	$12,609	About average	$10,977	$64,906
Paoli HospitalPaoli, PA · CCN 390153	177	$12,615	About average	$10,983	$42,200
Saint Anthony Medical CenterRockford, IL · CCN 140233	206	$12,619	About average	$10,984	$51,518
Rothman Orthopaedic Specialty HospitalBensalem, PA · CCN 390322	713	$12,620	About average	$10,987	$54,930
St Luke's Hospital - Easton CampusEaston, PA · CCN 390162	88	$12,621	About average	$10,989	$92,155
Cascade Valley HospitalArlington, WA · CCN 500060	30	$12,633	About average	$11,001	$48,360
Northwest Medical Center SahuaritaSahuarita, AZ · CCN 030148	62	$12,634	About average	$11,000	$124,230
Olmsted Medical CenterRochester, MN · CCN 240006 · +$386 outlier payments per case	130	$12,640	About average	$11,008	$40,990
Crozer Chester Medical CenterUpland, PA · CCN 390180	61	$12,642	About average	$11,017	$68,987

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.