Outpatient procedure · APC 5116 · Surgery or procedure

Level 6 Musculoskeletal Procedures

In 2024, Medicare and patients paid an average of $17,392 per procedure at 1,481 hospitals. Half of hospitals averaged between $16,055 and $18,131.

Also known as: Orthopedic surgery, arthroscopy, outpatient joint surgery

National figures, 2024

Average payment per case: $17,392
Typical range (middle half of hospitals): $16,055–$18,131
Medicare’s share: $15,76391% of the payment
Average billed charge: $97,523
Hospitals reporting: 1,48173,440 procedures

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1,479 hospitals reported at least 11 Medicare procedures for this in 2024; showing 1,301–1,350. Download as CSV

Medicare payments per case for Level 6 Musculoskeletal Procedures by hospital, 2024
Hospital	Cases	Average payment	vs national average	Medicare paid	Billed charge
Carson Tahoe Regional Medical CenterCarson City, NV · CCN 290019	76	$19,962	15% above the national average	$18,326	$69,468
Peconic Bay Medical CenterRiverhead, NY · CCN 330107	24	$19,965	15% above the national average	$18,333	$93,145
Baystate Noble HospitalWestfield, MA · CCN 220065	18	$19,966	15% above the national average	$18,334	$39,202
Beth Israel Deaconess Medical CenterBoston, MA · CCN 220086	25	$19,966	15% above the national average	$18,334	$34,821
Brigham And Women Faulkner HospitalJamaica Plain, MA · CCN 220119	67	$19,966	15% above the national average	$18,334	$55,549
Cape Cod HospitalHyannis, MA · CCN 220012	81	$19,966	15% above the national average	$18,334	$31,993
Holy Family HospitalMethuen, MA · CCN 220080	20	$19,966	15% above the national average	$18,334	$57,927
Lowell General HospitalLowell, MA · CCN 220063	22	$19,966	15% above the national average	$18,334	$35,227
MelroseWakefield HealthcareMelrose, MA · CCN 220070	17	$19,966	15% above the national average	$18,334	$42,911
Mercy Medical CenterSpringfield, MA · CCN 220066	17	$19,966	15% above the national average	$18,334	$49,512
Merrimack Health Lawrence HospitalLawrence, MA · CCN 220010	24	$19,966	15% above the national average	$18,334	$42,766
Sturdy Memorial HospitalAttleboro, MA · CCN 220008	26	$19,966	15% above the national average	$18,334	$52,860
Winchester HospitalWinchester, MA · CCN 220105	23	$19,966	15% above the national average	$18,334	$40,313
Beth Israel Deaconess Hospital PlymouthPlymouth, MA · CCN 220060	38	$19,966	15% above the national average	$18,334	$52,634
Lahey Hospital & Medical Center, BurlingtonBurlington, MA · CCN 220171	41	$19,966	15% above the national average	$18,334	$31,825
Massachusetts General HospitalBoston, MA · CCN 220071	194	$19,966	15% above the national average	$18,334	$79,590
Milford Regional Medical CenterMilford, MA · CCN 220090	40	$19,966	15% above the national average	$18,334	$38,549
Mount Auburn HospitalCambridge, MA · CCN 220002	40	$19,966	15% above the national average	$18,334	$31,690
Southcoast Hospitals GroupFall River, MA · CCN 220074	34	$19,966	15% above the national average	$18,334	$80,454
St Vincent HospitalWorcester, MA · CCN 220176	11	$19,966	15% above the national average	$18,334	$147,997
The Cooley Dickinson Hospital IncNorthampton, MA · CCN 220015	14	$19,966	15% above the national average	$18,334	$44,318
UMass Memorial HealthAlliance HospitalsLeominster, MA · CCN 220001	13	$19,966	15% above the national average	$18,334	$105,437
Emerson Hospital -W Concord, MA · CCN 220084	45	$19,966	15% above the national average	$18,333	$35,682
Northeast Hospital CorporationBeverly, MA · CCN 220033	49	$19,966	15% above the national average	$18,332	$33,427
UMass Memorial Medical Center/University CampusWorcester, MA · CCN 220163	56	$19,966	15% above the national average	$18,329	$99,418
North Shore Medical Center -Salem, MA · CCN 220035	44	$19,966	15% above the national average	$18,328	$53,861
Newton-Wellesley HospitalNewton, MA · CCN 220101	103	$19,966	15% above the national average	$18,328	$56,287
Yakima Valley MemorialYakima, WA · CCN 500036	47	$19,983	15% above the national average	$18,348	$46,706
Providence St Mary Medical CenterWalla Walla, WA · CCN 500002	25	$19,983	15% above the national average	$18,343	$79,041
John Dempsey Hospital Of The University Of ConnectFarmington, CT · CCN 070036	26	$20,002	15% above the national average	$18,370	$95,188
Putnam Hospital CenterCarmel, NY · CCN 330273	17	$20,004	15% above the national average	$18,372	$108,172
Mat-Su Regional Medical CenterPalmer, AK · CCN 020006 · +$3,244 outlier payments per case	87	$20,115	16% above the national average	$18,483	$362,365
Bay Area HospitalCoos Bay, OR · CCN 380090	19	$20,311	17% above the national average	$18,679	$66,193
Clovis Community Medical CenterClovis, CA · CCN 050492	16	$20,322	17% above the national average	$18,686	$101,905
Holy Name Medical CenterTeaneck, NJ · CCN 310008	25	$20,372	17% above the national average	$18,740	$78,755
The Queens Medical CenterHonolulu, HI · CCN 120001	38	$20,418	17% above the national average	$18,786	$74,288
Nyu Langone HospitalsNew York, NY · CCN 330214 · +$343 outlier payments per case	162	$20,460	18% above the national average	$18,827	$236,778
Yale-New Haven HospitalNew Haven, CT · CCN 070022	45	$20,491	18% above the national average	$18,859	$55,112
Hartford HospitalHartford, CT · CCN 070025	81	$20,501	18% above the national average	$18,869	$53,846
MidState Medical CenterMeriden, CT · CCN 070017	85	$20,512	18% above the national average	$18,880	$53,925
Morristown Medical CenterMorristown, NJ · CCN 310015	162	$20,647	19% above the national average	$19,010	$89,805
Hospital For Special SurgeryNew York, NY · CCN 330270	156	$20,691	19% above the national average	$19,059	$99,093
Overlook Medical CenterSummit, NJ · CCN 310051	92	$20,710	19% above the national average	$19,077	$104,754
Lawrence & Memorial HospitalNew London, CT · CCN 070007	46	$20,737	19% above the national average	$19,105	$51,949
Saint Mary's HospitalWaterbury, CT · CCN 070016	20	$20,737	19% above the national average	$19,105	$64,113
St Francis Hospital & Medical CenterHartford, CT · CCN 070002	65	$20,737	19% above the national average	$19,105	$66,801
Charlotte Hungerford HospitalTorrington, CT · CCN 070011	13	$20,737	19% above the national average	$19,105	$52,265
Waterbury HospitalWaterbury, CT · CCN 070005	13	$20,737	19% above the national average	$19,105	$95,958
William W Backus HospitalNorwich, CT · CCN 070024	17	$20,737	19% above the national average	$19,105	$60,159
Good Samaritan Hospital Medical CenterWest Islip, NY · CCN 330286	24	$20,762	19% above the national average	$19,130	$95,726

National trend

Average payment and billed charge per procedure, and how many Medicare procedures were reported each year.

Average payment
Average billed charge

2020: 1,457 procedures at 85 hospitals · 2021: 8,226 procedures at 353 hospitals · 2022: 3,004 procedures at 156 hospitals · 2023: 14,620 procedures at 540 hospitals · 2024: 73,440 procedures at 1,481 hospitals

View data as a table

National average payment and billed charge for Level 6 Musculoskeletal Procedures
Year of care	Average payment	Average billed charge
2020	$15K	$75K
2021	$15K	$116K
2022	$16K	$92K
2023	$21K	$112K
2024	$17K	$98K

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 6 Musculoskeletal Procedures, 2024
State	Hospitals	Cases	Average payment	Typical range
Vermont	3	119	$8,999	$8,453–$10,624
Alabama	25	1,210	$15,164	$14,755–$15,349
Utah	23	1,080	$15,193	$16,244–$16,659
Tennessee	33	2,084	$15,325	$15,130–$15,866
Mississippi	14	683	$15,430	$15,026–$15,570
Louisiana	30	1,108	$15,576	$15,464–$15,754
West Virginia	12	558	$15,715	$14,973–$15,721
Oklahoma	30	1,351	$15,834	$15,611–$16,023
Arkansas	21	1,202	$15,872	$15,523–$16,345
South Carolina	30	1,929	$15,906	$15,619–$16,100
Ohio	73	3,030	$15,978	$15,826–$16,279
Kentucky	22	1,410	$16,042	$15,742–$16,096
Kansas	23	1,240	$16,065	$15,767–$16,241
Iowa	20	1,326	$16,087	$15,847–$16,340
Missouri	35	1,775	$16,103	$15,799–$16,551
Virginia	41	2,439	$16,328	$15,963–$17,432
Texas	127	5,228	$16,373	$16,124–$16,789
Michigan	44	1,746	$16,380	$15,785–$17,123
Georgia	42	1,898	$16,409	$15,899–$17,257
North Carolina	45	2,608	$16,492	$16,184–$16,710
Indiana	47	2,034	$16,575	$16,509–$16,797
Florida	86	5,085	$16,629	$16,634–$16,845
Nebraska	16	1,011	$16,771	$16,741–$16,936
Wisconsin	38	1,368	$16,885	$16,647–$17,067
Idaho	13	741	$16,900	$16,735–$17,428
New Mexico	9	300	$17,126	$15,882–$17,343
Maine	7	292	$17,280	$16,837–$17,471
Pennsylvania	65	3,133	$17,344	$16,610–$17,938
Illinois	56	2,463	$17,391	$17,185–$17,654
North Dakota	6	437	$17,467	$17,235–$18,360
South Dakota	10	790	$17,472	$17,281–$18,289
Montana	9	516	$17,606	$17,193–$18,232
Colorado	37	2,121	$17,744	$17,468–$17,701
Minnesota	27	1,383	$18,117	$17,504–$18,536
Wyoming	8	289	$18,154	$18,579–$18,669
New Hampshire	11	403	$18,184	$17,654–$18,332
Arizona	37	2,369	$18,231	$17,996–$18,131
Delaware	5	457	$18,546	$18,654–$18,654
Rhode Island	3	157	$18,657	$18,634–$18,765
District of Columbia	4	199	$18,848	$18,878–$19,023
Washington	33	1,628	$19,062	$18,661–$19,156
Alaska	3	180	$19,345	$18,819–$19,653
New Jersey	28	1,653	$19,847	$19,222–$20,663
Oregon	20	929	$19,883	$19,066–$19,507
Massachusetts	34	1,711	$19,887	$19,966–$19,966
New York	51	1,970	$19,922	$19,552–$20,841
Nevada	9	617	$19,943	$19,802–$19,910
Connecticut	16	778	$20,733	$20,681–$20,925
Hawaii	3	70	$21,247	$21,066–$22,304
California	97	4,332	$23,412	$22,851–$23,737

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.