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 1,351–1,400. 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
St Charles HospitalPort Jefferson, NY · CCN 330246	18	$20,762	19% above the national average	$19,130	$80,256
SUNY/Stony Brook University HospitalStony Brook, NY · CCN 330393	17	$20,762	19% above the national average	$19,130	$73,431
Danbury HospitalDanbury, CT · CCN 070033	61	$20,793	20% above the national average	$19,161	$94,623
Valley HospitalParamus, NJ · CCN 310012	68	$20,866	20% above the national average	$19,228	$72,433
St Anthony Community HospitalWarwick, NY · CCN 330205	60	$20,920	20% above the national average	$19,288	$140,517
Norwalk HospitalNorwalk, CT · CCN 070034	13	$20,920	20% above the national average	$19,288	$88,708
Saint Clare's Hospital/ Denville CampusDenville, NJ · CCN 310050	18	$20,920	20% above the national average	$19,276	$145,925
Greenwich Hospital Association -Greenwich, CT · CCN 070018 · +$1,042 outlier payments per case	90	$20,939	20% above the national average	$19,307	$103,551
Middlesex HospitalMiddletown, CT · CCN 070020	22	$20,939	20% above the national average	$19,307	$73,330
Stamford HospitalStamford, CT · CCN 070006	137	$20,939	20% above the national average	$19,307	$102,840
St Vincent's Medical CenterBridgeport, CT · CCN 070028	44	$20,939	20% above the national average	$19,307	$76,162
Hackensack University Medical CenterHackensack, NJ · CCN 310001 · +$200 outlier payments per case	184	$20,941	20% above the national average	$19,307	$85,781
Mount Sinai South NassauOceanside, NY · CCN 330198	18	$20,946	20% above the national average	$19,314	$98,265
St Francis Hospital - The Heart CenterRoslyn, NY · CCN 330182	67	$20,946	20% above the national average	$19,314	$102,243
Berkshire Medical CenterPittsfield, MA · CCN 220046	12	$20,967	21% above the national average	$19,335	$85,868
White Plains Hospital CenterWhite Plains, NY · CCN 330304	50	$21,082	21% above the national average	$19,450	$111,854
Adventist Health Sierra VistaSan Luis Obispo, CA · CCN 050506	12	$21,087	21% above the national average	$19,455	$213,655
Bassett HealthcareCooperstown, NY · CCN 330136	19	$21,108	21% above the national average	$19,476	$52,146
Cayuga Medical Center At IthacaIthaca, NY · CCN 330307	16	$21,108	21% above the national average	$19,476	$77,511
Olean General HospitalOlean, NY · CCN 330103	12	$21,108	21% above the national average	$19,476	$36,413
Englewood Hospital And Medical CenterEnglewood, NJ · CCN 310045	21	$21,153	22% above the national average	$19,521	$327,118
Hackensack Meridian Health Pascack Valley MedicalWestwood, NJ · CCN 310130	21	$21,153	22% above the national average	$19,521	$67,568
Hudson Regional HospitalSecaucus, NJ · CCN 310118	19	$21,153	22% above the national average	$19,521	$163,733
Hudson Valley Hospital CenterCortlandt Manor, NY · CCN 330267	11	$21,153	22% above the national average	$19,521	$63,311
Mount Sinai HospitalNew York, NY · CCN 330024	27	$21,153	22% above the national average	$19,521	$63,050
New York Community Hospital Of Brooklyn, Inc.Brooklyn, NY · CCN 330019	15	$21,153	22% above the national average	$19,521	$40,554
New York-Presbyterian HospitalNew York, NY · CCN 330101	147	$21,153	22% above the national average	$19,521	$70,216
Nyack HospitalNyack, NY · CCN 330104	19	$21,153	22% above the national average	$19,521	$76,577
Staten Island University HospitalStaten Island, NY · CCN 330160	13	$21,153	22% above the national average	$19,521	$93,215
Los Robles Hospital & Medical CenterThousand Oaks, CA · CCN 050549	30	$21,445	23% above the national average	$19,805	$330,038
San Antonio Regional HospitalUpland, CA · CCN 050099	16	$21,525	24% above the national average	$19,893	$98,558
Wilcox Memorial HospitalLihue, HI · CCN 120014	18	$21,714	25% above the national average	$20,082	$73,371
Saint John's Health CenterSanta Monica, CA · CCN 050290	42	$21,887	26% above the national average	$20,255	$82,951
Patients' Hospital Of ReddingRedding, CA · CCN 050697	24	$21,942	26% above the national average	$20,342	$128,816
MemorialCare Long Beach Medical CenterLong Beach, CA · CCN 050485	26	$22,035	27% above the national average	$20,403	$84,765
Community Memorial Hospital - VenturaVentura, CA · CCN 050394	77	$22,066	27% above the national average	$20,434	$82,254
Cedar-Sinai Marina Del Rey HospitalMarina Del Rey, CA · CCN 050740	32	$22,196	28% above the national average	$20,564	$128,095
Sutter Surgical Hospital - North ValleyYuba City, CA · CCN 050766 · +$1,206 outlier payments per case	27	$22,220	28% above the national average	$20,588	$105,388
Providence Medford Medical CenterMedford, OR · CCN 380075	63	$22,235	28% above the national average	$20,603	$58,401
Huntington HospitalPasadena, CA · CCN 050438	35	$22,245	28% above the national average	$20,613	$123,149
Goleta Valley Cottage HospitalSanta Barbara, CA · CCN 050357	65	$22,249	28% above the national average	$20,626	$99,852
Uci Health-OrangeOrange, CA · CCN 050348	39	$22,310	28% above the national average	$20,675	$115,752
Asante Rogue Regional Medical CenterMedford, OR · CCN 380018	86	$22,324	28% above the national average	$20,688	$83,029
Santa Monica - UCLA Medical Center & Orthopaedic HospitalSanta Monica, CA · CCN 050112	82	$22,334	28% above the national average	$20,702	$83,926
Doctors Medical CenterModesto, CA · CCN 050464	42	$22,346	28% above the national average	$20,703	$191,353
Mercy Medical CenterMerced, CA · CCN 050444	36	$22,347	28% above the national average	$20,734	$66,791
Fresno Surgical HospitalFresno, CA · CCN 050708	101	$22,431	29% above the national average	$20,799	$52,639
Northern Nevada Medical CenterSparks, NV · CCN 290032	32	$22,567	30% above the national average	$20,935	$182,700
Grossmont HospitalLa Mesa, CA · CCN 050026	76	$22,574	30% above the national average	$20,940	$119,855
Cedars-Sinai Medical CenterLos Angeles, CA · CCN 050625	113	$22,664	30% above the national average	$21,031	$267,265

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.