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 1,401–1,450. 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
Scripps Green HospitalLa Jolla, CA · CCN 050424	119	$22,673	30% above the national average	$21,041	$147,109
Bakersfield Memorial HospitalBakersfield, CA · CCN 050036	31	$22,822	31% above the national average	$21,190	$143,521
Adventist Health BakersfieldBakersfield, CA · CCN 050455	34	$22,851	31% above the national average	$21,219	$170,317
Adventist Health Twin CitiesTempleton, CA · CCN 050633	20	$22,851	31% above the national average	$21,219	$188,046
Community Regional Medical CenterFresno, CA · CCN 050060	18	$22,851	31% above the national average	$21,219	$119,787
Enloe HealthChico, CA · CCN 050039	26	$22,851	31% above the national average	$21,219	$109,872
Kaweah Health Medical CenterVisalia, CA · CCN 050057	69	$22,851	31% above the national average	$21,219	$49,320
Loma Linda University Medical CenterLoma Linda, CA · CCN 050327	48	$22,851	31% above the national average	$21,219	$128,188
Marian Regional Medical CenterSanta Maria, CA · CCN 050107	40	$22,851	31% above the national average	$21,219	$125,383
MemorialCare Saddleback Medical CenterLaguna Hills, CA · CCN 050603	22	$22,851	31% above the national average	$21,219	$110,235
Memorial Medical CenterModesto, CA · CCN 050557	33	$22,851	31% above the national average	$21,219	$98,508
Mercy Medical Center ReddingRedding, CA · CCN 050280	50	$22,851	31% above the national average	$21,219	$84,551
Northridge Hospital Medical CenterNorthridge, CA · CCN 050116	32	$22,851	31% above the national average	$21,219	$145,913
Providence Cedars Sinai Tarzana Medical CenterTarzana, CA · CCN 050761	28	$22,851	31% above the national average	$21,219	$116,678
Providence Little Company Of Mary Medical Center TorranceTorrance, CA · CCN 050353	16	$22,851	31% above the national average	$21,219	$115,483
Providence Saint Joseph Medical CenterBurbank, CA · CCN 050235	33	$22,851	31% above the national average	$21,219	$129,353
Saint Agnes Medical CenterFresno, CA · CCN 050093	21	$22,851	31% above the national average	$21,219	$109,011
Scripps Memorial Hospital - EncinitasEncinitas, CA · CCN 050503	27	$22,851	31% above the national average	$21,219	$187,931
Sharp Memorial HospitalSan Diego, CA · CCN 050100	32	$22,851	31% above the national average	$21,219	$130,020
Shasta Regional Medical CenterRedding, CA · CCN 050764	25	$22,851	31% above the national average	$21,219	$149,531
Southwest Healthcare Rancho Springs HospitalMurrieta, CA · CCN 050701	25	$22,851	31% above the national average	$21,219	$97,141
St Bernardine Medical CenterSan Bernardino, CA · CCN 050129	16	$22,851	31% above the national average	$21,219	$88,462
Temecula Valley HospitalTemecula, CA · CCN 050775	15	$22,851	31% above the national average	$21,219	$111,576
Tri-City Medical CenterOceanside, CA · CCN 050128	23	$22,851	31% above the national average	$21,219	$101,126
UCLA West Valley Medical CenterWest Hills, CA · CCN 050481	15	$22,851	31% above the national average	$21,219	$301,746
Adventist Health HanfordHanford, CA · CCN 050121	13	$22,851	31% above the national average	$21,219	$117,383
French Hospital Medical CenterSan Luis Obispo, CA · CCN 050232	107	$22,851	31% above the national average	$21,219	$127,114
MemorialCare Orange Coast Medical CenterFountain Valley, CA · CCN 050678	13	$22,851	31% above the national average	$21,219	$117,509
PIH Health Hospital-WhittierWhittier, CA · CCN 050169	11	$22,851	31% above the national average	$21,219	$99,967
Providence Holy Cross Medical CenterMission Hills, CA · CCN 050278	13	$22,851	31% above the national average	$21,219	$111,927
Scripps Memorial Hospital La JollaLa Jolla, CA · CCN 050324	14	$22,851	31% above the national average	$21,219	$252,999
Eisenhower Medical CenterRancho Mirage, CA · CCN 050573	280	$22,851	31% above the national average	$21,219	$87,540
Providence St. Jude Medical CenterFullerton, CA · CCN 050168	60	$22,851	31% above the national average	$21,219	$84,277
Torrance Memorial Medical CenterTorrance, CA · CCN 050351	29	$22,851	31% above the national average	$21,218	$76,923
Keck Hospital Of USCLos Angeles, CA · CCN 050696	59	$22,852	31% above the national average	$21,218	$107,114
Adventist Health White MemorialLos Angeles, CA · CCN 050103	55	$22,852	31% above the national average	$21,218	$232,027
Hoag Orthopedic InstituteIrvine, CA · CCN 050769	252	$22,852	31% above the national average	$21,217	$115,075
UCSan Diego Health Hillcrest - Hillcrest Medical CenterSan Diego, CA · CCN 050025	66	$22,852	31% above the national average	$21,216	$83,950
Providence Mission HospitalMission Viejo, CA · CCN 050567	83	$22,852	31% above the national average	$21,211	$120,758
Providence St Joseph HospitalEureka, CA · CCN 050006	57	$22,852	31% above the national average	$21,207	$108,804
Redlands Community HospitalRedlands, CA · CCN 050272	29	$22,852	31% above the national average	$21,203	$121,388
Kona Community HospitalKealakekua, HI · CCN 120019	14	$22,895	32% above the national average	$21,263	$90,600
Sierra Nevada Memorial HospitalGrass Valley, CA · CCN 050150	29	$22,975	32% above the national average	$21,334	$85,411
University Of California Davis Medical CenterSacramento, CA · CCN 050599	79	$23,168	33% above the national average	$21,536	$149,161
Dameron HospitalStockton, CA · CCN 050122	25	$23,341	34% above the national average	$21,709	$241,075
Stanislaus Surgical HospitalModesto, CA · CCN 050726	11	$23,349	34% above the national average	$21,717	$116,146
Sutter Roseville Medical CenterRoseville, CA · CCN 050309	73	$23,434	35% above the national average	$21,802	$102,112
Mercy General HospitalSacramento, CA · CCN 050017	39	$23,737	36% above the national average	$22,105	$134,157
Barton Memorial HospitalSouth Lake Tahoe, CA · CCN 050352	33	$23,737	36% above the national average	$22,105	$168,009
Marshall Medical CenterPlacerville, CA · CCN 050254	25	$23,737	36% above the national average	$22,105	$211,879

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.