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 1,901–1,950. 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
UPMC ChautauquaJamestown, NY · CCN 330239	38	$13,930	12% above the national average	$12,297	$43,065
Geneva General HospitalGeneva, NY · CCN 330058	26	$13,930	12% above the national average	$12,297	$23,836
Ellis HospitalSchenectady, NY · CCN 330153	64	$13,930	12% above the national average	$12,294	$40,182
Samaritan Hospital Of Troy, New YorkTroy, NY · CCN 330180	13	$13,930	12% above the national average	$12,289	$26,582
Rome Memorial Hospital, IncRome, NY · CCN 330215	19	$13,930	12% above the national average	$12,286	$35,106
Confluence Health HospitalWenatchee, WA · CCN 500016 · +$58 outlier payments per case	427	$13,931	12% above the national average	$12,299	$53,136
Marlborough HospitalMarlborough, MA · CCN 220049	70	$13,932	12% above the national average	$12,299	$67,367
Chenango Memorial HospitalNorwich, NY · CCN 330033	27	$13,932	12% above the national average	$12,299	$76,000
Anna Jaques HospitalNewburyport, MA · CCN 220029	143	$13,935	12% above the national average	$12,303	$22,703
The Cooley Dickinson Hospital IncNorthampton, MA · CCN 220015	145	$13,938	12% above the national average	$12,306	$47,536
St Vincent HospitalWorcester, MA · CCN 220176	153	$13,950	12% above the national average	$12,309	$114,847
Samaritan HospitalMoses Lake, WA · CCN 500033	73	$13,951	12% above the national average	$12,318	$77,941
Lowell General HospitalLowell, MA · CCN 220063	247	$13,959	13% above the national average	$12,326	$27,201
MelroseWakefield HealthcareMelrose, MA · CCN 220070	87	$13,967	13% above the national average	$12,334	$27,796
Northern Westchester HospitalMount Kisco, NY · CCN 330162	261	$13,969	13% above the national average	$12,336	$63,320
St Michael Medical CenterSilverdale, WA · CCN 500039	326	$13,969	13% above the national average	$12,336	$96,684
North Shore Medical Center -Salem, MA · CCN 220035	269	$13,975	13% above the national average	$12,340	$38,034
Southcoast Hospitals GroupFall River, MA · CCN 220074	186	$13,979	13% above the national average	$12,347	$43,077
Newton-Wellesley HospitalNewton, MA · CCN 220101	675	$13,980	13% above the national average	$12,347	$32,683
Renown South Meadows Medical CenterReno, NV · CCN 290049	508	$13,981	13% above the national average	$12,348	$53,375
UMass Memorial HealthAlliance HospitalsLeominster, MA · CCN 220001	102	$13,987	13% above the national average	$12,353	$63,180
Brigham And Women Faulkner HospitalJamaica Plain, MA · CCN 220119	552	$13,999	13% above the national average	$12,366	$34,573
North Shore University HospitalManhasset, NY · CCN 330106	320	$14,004	13% above the national average	$12,370	$57,623
Massachusetts General HospitalBoston, MA · CCN 220071	624	$14,010	13% above the national average	$12,378	$50,594
New England Baptist HospitalBoston, MA · CCN 220088	1,432	$14,017	13% above the national average	$12,385	$28,062
Winchester HospitalWinchester, MA · CCN 220105	283	$14,022	13% above the national average	$12,390	$25,945
Baystate Medical CenterSpringfield, MA · CCN 220077	741	$14,026	13% above the national average	$12,393	$29,034
Falmouth HospitalFalmouth, MA · CCN 220135	152	$14,028	13% above the national average	$12,396	$29,860
Yakima Valley MemorialYakima, WA · CCN 500036	254	$14,028	13% above the national average	$12,395	$36,077
New York-Presbyterian/QueensFlushing, NY · CCN 330055	29	$14,030	13% above the national average	$12,398	$40,598
South Shore HospitalSouth Weymouth, MA · CCN 220100	286	$14,030	13% above the national average	$12,400	$21,439
Vassar Brothers Medical CenterPoughkeepsie, NY · CCN 330023	14	$14,032	13% above the national average	$12,400	$53,451
SUNY/Stony Brook University HospitalStony Brook, NY · CCN 330393	100	$14,033	13% above the national average	$12,400	$45,384
Milford Regional Medical CenterMilford, MA · CCN 220090	147	$14,040	13% above the national average	$12,413	$24,188
Providence St Mary Medical CenterWalla Walla, WA · CCN 500002	182	$14,053	13% above the national average	$12,421	$50,432
Cape Cod HospitalHyannis, MA · CCN 220012	480	$14,058	13% above the national average	$12,426	$29,009
University Medical CenterLas Vegas, NV · CCN 290007	28	$14,071	13% above the national average	$12,439	$129,925
Beth Israel Deaconess Hospital PlymouthPlymouth, MA · CCN 220060	371	$14,076	13% above the national average	$12,443	$37,513
Swedish Medical Center / Cherry HillSeattle, WA · CCN 500025	11	$14,078	14% above the national average	$12,446	$85,979
Beth Israel Deaconess Medical CenterBoston, MA · CCN 220086	51	$14,110	14% above the national average	$12,478	$27,580
Heywood Hospital -Gardner, MA · CCN 220095	57	$14,110	14% above the national average	$12,478	$33,367
Merrimack Health Lawrence HospitalLawrence, MA · CCN 220010	73	$14,110	14% above the national average	$12,478	$29,227
Holyoke Medical CenterHolyoke, MA · CCN 220024	48	$14,110	14% above the national average	$12,478	$35,885
Emerson Hospital -W Concord, MA · CCN 220084	170	$14,110	14% above the national average	$12,477	$30,115
Havasu Regional Medical CenterLake Havasu City, AZ · CCN 030069	252	$14,122	14% above the national average	$12,488	$118,819
Salem HospitalSalem, OR · CCN 380051	309	$14,165	14% above the national average	$12,532	$52,953
HealthAlliance Hospital Marys Avenue CampusKingston, NY · CCN 330224	20	$14,206	15% above the national average	$12,574	$39,356
Plainview HospitalPlainview, NY · CCN 330331	50	$14,223	15% above the national average	$12,591	$51,235
Olean General HospitalOlean, NY · CCN 330103	39	$14,240	15% above the national average	$12,603	$35,107
Mount Sinai WestNew York, NY · CCN 330046	129	$14,289	15% above the national average	$12,655	$41,998

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.