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 1,951–2,000. 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
Mat-Su Regional Medical CenterPalmer, AK · CCN 020006	233	$14,301	15% above the national average	$12,669	$135,371
Northern Dutchess HospitalRhinebeck, NY · CCN 330049	244	$14,320	15% above the national average	$12,687	$33,634
PeaceHealth St John Medical CenterLongview, WA · CCN 500041	48	$14,337	16% above the national average	$12,705	$94,926
St Anthony Community HospitalWarwick, NY · CCN 330205	112	$14,339	16% above the national average	$12,706	$109,395
Bay Area HospitalCoos Bay, OR · CCN 380090	42	$14,353	16% above the national average	$12,721	$47,833
Fairbanks Memorial HospitalFairbanks, AK · CCN 020012	49	$14,366	16% above the national average	$12,734	$49,382
The Queens Medical CenterHonolulu, HI · CCN 120001	185	$14,376	16% above the national average	$12,738	$67,099
Waterbury HospitalWaterbury, CT · CCN 070005	54	$14,413	16% above the national average	$12,781	$65,593
MidState Medical CenterMeriden, CT · CCN 070017	622	$14,417	16% above the national average	$12,786	$31,232
Montefiore Medical CenterBronx, NY · CCN 330059	36	$14,435	16% above the national average	$12,799	$74,611
John Dempsey Hospital Of The University Of ConnectFarmington, CT · CCN 070036	61	$14,441	16% above the national average	$12,809	$56,255
St Charles HospitalPort Jefferson, NY · CCN 330246	284	$14,443	16% above the national average	$12,811	$65,199
William W Backus HospitalNorwich, CT · CCN 070024	64	$14,451	17% above the national average	$12,819	$38,055
Garnet Health Medical CenterMiddletown, NY · CCN 330126	255	$14,472	17% above the national average	$12,843	$40,428
Saint Mary's HospitalWaterbury, CT · CCN 070016	37	$14,478	17% above the national average	$12,846	$48,270
Pali Momi Medical CenterAiea, HI · CCN 120026	43	$14,481	17% above the national average	$12,849	$39,477
St Francis Hospital & Medical CenterHartford, CT · CCN 070002	303	$14,484	17% above the national average	$12,850	$47,195
Maui Memorial Medical CenterWailuku, HI · CCN 120002	25	$14,484	17% above the national average	$12,842	$42,882
Yale-New Haven HospitalNew Haven, CT · CCN 070022	174	$14,487	17% above the national average	$12,852	$40,003
Montefiore St Luke's CornwallNewburgh, NY · CCN 330264	59	$14,496	17% above the national average	$12,864	$38,301
Providence Centralia HospitalCentralia, WA · CCN 500019	74	$14,496	17% above the national average	$12,864	$74,270
Staten Island University HospitalStaten Island, NY · CCN 330160	148	$14,498	17% above the national average	$12,866	$53,206
Jersey City Medical CenterJersey City, NJ · CCN 310074	60	$14,504	17% above the national average	$12,868	$52,685
Central Peninsula General HospitalSoldotna, AK · CCN 020024 · +$203 outlier payments per case	98	$14,522	17% above the national average	$12,890	$77,377
Bartlett Regional HospitalJuneau, AK · CCN 020008	37	$14,522	17% above the national average	$12,890	$48,355
The University Of Vermont Health Network - ChamplPlattsburgh, NY · CCN 330250	66	$14,523	17% above the national average	$12,891	$39,688
Lenox Hill HospitalNew York, NY · CCN 330119	61	$14,530	17% above the national average	$12,912	$53,843
St Vincent's Medical CenterBridgeport, CT · CCN 070028	247	$14,531	17% above the national average	$12,898	$51,188
Westchester Medical CenterValhalla, NY · CCN 330234	171	$14,534	17% above the national average	$12,902	$90,783
Hartford HospitalHartford, CT · CCN 070025	477	$14,546	17% above the national average	$12,913	$32,812
Adirondack Medical Center - Saranac LakeSaranac Lake, NY · CCN 330079	76	$14,567	17% above the national average	$12,935	$42,335
St Joseph's University Medical Center IncPaterson, NJ · CCN 310019 · +$109 outlier payments per case	140	$14,568	17% above the national average	$12,934	$101,692
Morristown Medical CenterMorristown, NJ · CCN 310015	1,233	$14,577	18% above the national average	$12,945	$57,254
Good Samaritan Hospital Medical CenterWest Islip, NY · CCN 330286	139	$14,579	18% above the national average	$12,946	$83,220
St Joseph HospitalBethpage, NY · CCN 330332	59	$14,579	18% above the national average	$12,946	$75,417
Straub Clinic And HospitalHonolulu, HI · CCN 120022	135	$14,587	18% above the national average	$12,966	$53,236
Hospital For Special SurgeryNew York, NY · CCN 330270 · +$133 outlier payments per case	2,670	$14,605	18% above the national average	$12,972	$88,594
Mid-Columbia Medical CenterThe Dalles, OR · CCN 380001	26	$14,607	18% above the national average	$12,975	$41,355
Bridgeport HospitalBridgeport, CT · CCN 070010	163	$14,627	18% above the national average	$12,995	$44,004
White Plains Hospital CenterWhite Plains, NY · CCN 330304	319	$14,641	18% above the national average	$13,015	$78,795
Mount Sinai South NassauOceanside, NY · CCN 330198	175	$14,652	18% above the national average	$13,018	$60,856
Bristol HospitalBristol, CT · CCN 070029	20	$14,655	18% above the national average	$13,023	$61,849
Charlotte Hungerford HospitalTorrington, CT · CCN 070011	19	$14,655	18% above the national average	$13,023	$35,089
Lawrence & Memorial HospitalNew London, CT · CCN 070007	56	$14,655	18% above the national average	$13,023	$33,223
Manchester Memorial HospitalManchester, CT · CCN 070027	43	$14,655	18% above the national average	$13,023	$45,048
Windham Community Memorial HospitalWillimantic, CT · CCN 070021	26	$14,655	18% above the national average	$13,023	$36,926
Long Island Community HospitalPatchogue, NY · CCN 330141 · +$2,069 outlier payments per case	50	$14,672	18% above the national average	$13,040	$205,162
Nyu Langone HospitalsNew York, NY · CCN 330214 · +$66 outlier payments per case	1,083	$14,679	18% above the national average	$13,048	$188,372
Greenwich Hospital Association -Greenwich, CT · CCN 070018	386	$14,695	18% above the national average	$13,062	$68,386
Overlook Medical CenterSummit, NJ · CCN 310051	386	$14,716	19% above the national average	$13,083	$67,050

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.