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 1,851–1,900. 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
CentraState Medical CenterFreehold, NJ · CCN 310111	142	$13,754	11% above the national average	$12,122	$30,372
Ocean Medical CenterBrick, NJ · CCN 310052	540	$13,755	11% above the national average	$12,123	$38,151
Southern Ocean Medical CenterManahawkin, NJ · CCN 310113	16	$13,755	11% above the national average	$12,123	$49,156
Capital Health Medical Center - HopewellPennington, NJ · CCN 310044	142	$13,755	11% above the national average	$12,123	$144,999
Newton Medical CenterNewton, NJ · CCN 310028	22	$13,755	11% above the national average	$12,112	$111,435
Tufts Medical CenterBoston, MA · CCN 220116	110	$13,769	11% above the national average	$12,137	$33,701
Carson Tahoe Regional Medical CenterCarson City, NV · CCN 290019	115	$13,781	11% above the national average	$12,149	$45,720
Columbia Memorial HospitalHudson, NY · CCN 330094	85	$13,785	11% above the national average	$12,153	$30,017
Legacy Emanuel Medical CenterPortland, OR · CCN 380007	15	$13,786	11% above the national average	$12,154	$44,670
Legacy Mount Hood Medical CenterGresham, OR · CCN 380025	51	$13,786	11% above the national average	$12,154	$32,586
Providence Milwaukie HospitalMilwaukie, OR · CCN 380082	30	$13,786	11% above the national average	$12,154	$37,146
Providence Newberg Medical CenterNewberg, OR · CCN 380037	38	$13,786	11% above the national average	$12,154	$38,255
Providence St Vincent Medical CenterPortland, OR · CCN 380004	194	$13,786	11% above the national average	$12,154	$41,528
Willamette Valley Medical CenterMcminnville, OR · CCN 380071	31	$13,786	11% above the national average	$12,154	$82,868
Saint Vincent HospitalErie, PA · CCN 390009	221	$13,792	11% above the national average	$12,160	$86,417
UMass Memorial Medical Center/University CampusWorcester, MA · CCN 220163 · +$123 outlier payments per case	187	$13,796	11% above the national average	$12,163	$62,738
St Joseph's Hospital Health CenterSyracuse, NY · CCN 330140	191	$13,801	11% above the national average	$12,167	$40,796
Glens Falls HospitalGlens Falls, NY · CCN 330191 · +$215 outlier payments per case	98	$13,804	11% above the national average	$12,172	$42,355
Clifton Springs Hospital And ClinicClifton Springs, NY · CCN 330265	97	$13,805	11% above the national average	$12,170	$31,664
Saint Anne's HospitalFall River, MA · CCN 220020	62	$13,810	11% above the national average	$12,173	$42,324
JFK University Medical CenterEdison, NJ · CCN 310108	109	$13,811	11% above the national average	$12,194	$51,146
Jersey Shore University Medical CenterNeptune, NJ · CCN 310073	239	$13,825	11% above the national average	$12,192	$44,973
Albany Medical Center HospitalAlbany, NY · CCN 330013	127	$13,833	12% above the national average	$12,201	$25,463
Saint Peter's University HospitalNew Brunswick, NJ · CCN 310070	117	$13,834	12% above the national average	$12,199	$72,251
UMass Memorial Health - Harrington HospitalSouthbridge, MA · CCN 220019	46	$13,838	12% above the national average	$12,206	$50,063
Southern Hills Hospital And Medical CenterLas Vegas, NV · CCN 290047	109	$13,844	12% above the national average	$12,212	$164,502
Warren General HospitalWarren, PA · CCN 390146	49	$13,847	12% above the national average	$12,214	$26,127
Brown University Health Morton HospitalTaunton, MA · CCN 220073	97	$13,852	12% above the national average	$12,219	$35,994
Saratoga HospitalSaratoga Springs, NY · CCN 330222	324	$13,854	12% above the national average	$12,221	$37,339
Mercy Medical CenterRoseburg, OR · CCN 380027	156	$13,864	12% above the national average	$12,232	$57,460
Brigham And Women's HospitalBoston, MA · CCN 220110	194	$13,866	12% above the national average	$12,232	$60,723
Saint Rose Dominican Hospitals - Siena CampusHenderson, NV · CCN 290045	494	$13,872	12% above the national average	$12,240	$116,429
Riverview Medical CenterRed Bank, NJ · CCN 310034	458	$13,878	12% above the national average	$12,244	$40,685
Boston Medical CenterBoston, MA · CCN 220031	54	$13,879	12% above the national average	$12,247	$42,997
Putnam Hospital CenterCarmel, NY · CCN 330273	78	$13,890	12% above the national average	$12,256	$54,773
Swedish Medical CenterSeattle, WA · CCN 500027 · +$25 outlier payments per case	790	$13,890	12% above the national average	$12,257	$83,676
Olympic Medical CenterPort Angeles, WA · CCN 500072	167	$13,898	12% above the national average	$12,266	$31,644
Kaiser Foundation Hospital - AntiochAntioch, CA · CCN 050760	16	$13,900	12% above the national average	$12,208	$70,286
Beth Israel Deaconess Hospital - NeedhamNeedham, MA · CCN 220083	60	$13,902	12% above the national average	$12,270	$24,511
University Medical Center Of Princeton At PlainsboroPlainsboro, NJ · CCN 310010	778	$13,909	12% above the national average	$12,277	$58,538
PeaceHealth St Joseph Medical CenterBellingham, WA · CCN 500030	313	$13,913	12% above the national average	$12,280	$71,068
Northeast Hospital CorporationBeverly, MA · CCN 220033	159	$13,913	12% above the national average	$12,284	$20,211
Mount Auburn HospitalCambridge, MA · CCN 220002	64	$13,915	12% above the national average	$12,282	$18,235
Sturdy Memorial HospitalAttleboro, MA · CCN 220008	132	$13,921	12% above the national average	$12,287	$36,487
Lahey Hospital & Medical Center, BurlingtonBurlington, MA · CCN 220171	199	$13,923	12% above the national average	$12,291	$22,587
Bertrand Chaffee HospitalSpringville, NY · CCN 330111	20	$13,930	12% above the national average	$12,298	$16,475
F F Thompson HospitalCanandaigua, NY · CCN 330074	26	$13,930	12% above the national average	$12,298	$35,424
Oneida Health HospitalOneida, NY · CCN 330115	38	$13,930	12% above the national average	$12,298	$50,707
Oswego HospitalOswego, NY · CCN 330218	18	$13,930	12% above the national average	$12,298	$31,855
St Marys HealthcareAmsterdam, NY · CCN 330047	26	$13,930	12% above the national average	$12,298	$24,396

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.