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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 Maine

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
Maine
Specific hospitals up to 10
Average payment across these 14 hospitals
$12,045National $12,402 · Maine $12,045
Median hospital
$12,042
Lowest to highest
$11,077–$12,731
Medicare procedures
1,590

14 hospitals reported at least 11 Medicare procedures for this in 2024. Download as CSV

Medicare payments per case for Level 5 Musculoskeletal Procedures by hospital, 2024
HospitalCasesAverage paymentvs national averageMedicare paidBilled charge
St Joseph HospitalBangor, ME · CCN 200001 · +$369 outlier payments per case143$11,07711% below the national average$9,442$51,122
Cary Medical CenterCaribou, ME · CCN 20003121$11,280About average$9,647$45,921
Northern Light A R Gould HospitalPresque Isle, ME · CCN 200018 · +$487 outlier payments per case32$11,280About average$9,640$61,641
St Mary's Regional Medical CenterLewiston, ME · CCN 20003433$11,412About average$9,780$77,015
Northern Light Eastern Maine Medical CenterBangor, ME · CCN 20003346$11,452About average$9,816$50,433
Central Maine Medical CenterLewiston, ME · CCN 200024 · +$3,485 outlier payments per case54$11,924About average$10,290$47,332
Mainehealth Mid Coast HospitalBrunswick, ME · CCN 20002162$12,006About average$10,371$41,888
Mainehealth Pen Bay HospitalRockport, ME · CCN 20006368$12,078About average$10,446$49,512
Northern Light Mercy HospitalPortland, ME · CCN 200008 · +$78 outlier payments per case355$12,197About average$10,565$47,688
Mainehealth Maine Medical CenterPortland, ME · CCN 200009 · +$135 outlier payments per case551$12,212About average$10,579$57,351
York HospitalYork, ME · CCN 200020 · +$374 outlier payments per case79$12,213About average$10,581$55,547
Southern Maine Health CareBiddeford, ME · CCN 20001954$12,348About average$10,716$48,070
Northern Light Maine Coast HospitalEllsworth, ME · CCN 20005026$12,505About average$10,873$62,996
Maine General Medical CenterAugusta, ME · CCN 20003966$12,731About average$11,097$49,300

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.