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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

Hospitals in California

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
California
Specific hospitals up to 10
Average payment across these 164 hospitals
$16,486National $12,402 · California $16,486
Median hospital
$16,148
Lowest to highest
$9,770–$18,892
Medicare procedures
27,002

164 hospitals reported at least 11 Medicare procedures for this in 2024; showing 151–164. Download as CSV

Medicare payments per case for Level 5 Musculoskeletal Procedures by hospital, 2024
HospitalCasesAverage paymentvs national averageMedicare paidBilled charge
Providence Queen Of The Valley Medical CenterNapa, CA · CCN 05000985$18,39048% above the national average$16,758$138,552
Providence Santa Rosa Memorial HospitalSanta Rosa, CA · CCN 050174118$18,39048% above the national average$16,758$171,714
UCSF Medical CenterSan Francisco, CA · CCN 050454233$18,41849% above the national average$16,786$95,650
UCSF Health St. Mary's HospitalSan Francisco, CA · CCN 05045749$18,41949% above the national average$16,785$82,802
Sequoia HospitalRedwood City, CA · CCN 050197299$18,43449% above the national average$16,801$130,111
Stanford Health Care Tri-ValleyPleasanton, CA · CCN 050283420$18,43749% above the national average$16,805$95,440
Washington HospitalFremont, CA · CCN 050195 · +$27 outlier payments per case991$18,45649% above the national average$16,824$142,177
Stanford Health CareStanford, CA · CCN 050441464$18,46149% above the national average$16,830$176,897
Community Hospital Of The Monterey PeninsulaMonterey, CA · CCN 050145177$18,49049% above the national average$16,858$69,287
Santa Clara Valley Medical CenterSan Jose, CA · CCN 05003819$18,49049% above the national average$16,858$61,423
Kaiser Foundation Hospital - VacavilleVacaville, CA · CCN 05076713$18,52649% above the national average$16,888$68,784
California Pacific Medical Center - Mission BernalSan Francisco, CA · CCN 05005523$18,76951% above the national average$17,137$80,219
Peninsula Medical CenterBurlingame, CA · CCN 050007149$18,76951% above the national average$17,137$85,650
NorthBay Medical CenterFairfield, CA · CCN 050367 · +$990 outlier payments per case115$18,89252% above the national average$17,257$256,656

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 careAverage paymentAverage 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
StateHospitalsCasesAverage paymentTypical range
Vermont6927$6,642$5,710–$7,857
Alabama365,517$10,733$10,538–$10,928
Mississippi251,977$10,843$10,672–$11,006
Tennessee478,201$10,865$10,654–$11,195
Louisiana445,417$10,909$10,733–$11,044
West Virginia192,033$11,015$10,538–$11,114
Ohio10415,215$11,123$11,029–$11,497
Oklahoma427,005$11,159$11,026–$11,326
Arkansas285,195$11,206$11,043–$11,679
South Carolina439,015$11,244$11,083–$11,366
Kentucky425,097$11,263$10,995–$11,552
Kansas346,049$11,345$11,166–$11,885
Iowa295,825$11,405$11,208–$11,925
Missouri538,629$11,419$11,333–$11,837
Virginia5513,156$11,531$11,183–$12,118
Michigan738,557$11,535$11,319–$11,944
Texas18827,220$11,614$11,350–$11,866
Georgia719,007$11,645$11,145–$12,011
North Carolina6511,812$11,652$11,347–$11,739
New Mexico162,050$11,704$11,270–$12,005
Utah323,863$11,712$11,479–$11,775
Indiana649,630$11,754$11,642–$11,909
Nebraska214,927$11,799$11,652–$12,128
Florida13323,438$11,799$11,730–$11,906
Idaho152,954$11,894$11,784–$12,386
Wisconsin567,721$11,921$11,695–$12,134
Maine141,590$12,045$11,422–$12,212
Pennsylvania10517,854$12,207$11,693–$12,571
Montana102,257$12,302$12,157–$12,991
Illinois8214,943$12,334$12,119–$12,518
South Dakota133,867$12,387$12,258–$13,048
North Dakota61,935$12,448$12,260–$12,787
Colorado478,262$12,564$12,388–$12,511
New Hampshire112,199$12,713$12,410–$12,672
Minnesota426,532$12,735$12,361–$12,965
Arizona479,066$12,802$12,653–$12,814
Wyoming10919$12,806$12,962–$13,194
Delaware62,342$13,085$13,029–$13,172
District of Columbia4774$13,274$13,278–$13,444
Rhode Island8825$13,278$13,310–$13,335
Washington437,875$13,453$13,133–$13,721
Alaska6992$13,858$13,747–$14,483
Oregon293,599$13,939$13,452–$13,786
Nevada162,147$13,956$13,488–$13,899
Massachusetts439,382$13,997$13,872–$14,027
New Jersey4310,137$14,069$13,614–$14,536
New York9113,630$14,226$13,725–$14,676
Connecticut233,597$14,579$14,481–$14,714
Hawaii9682$14,923$14,484–$15,494
California16427,002$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.