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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

Hospitals in California

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
California
Specific hospitals up to 10
Average payment across these 97 hospitals
$23,412National $17,392 · California $23,412
Median hospital
$22,851
Lowest to highest
$15,780–$26,563
Medicare procedures
4,332

97 hospitals reported at least 11 Medicare procedures for this in 2024; showing 1–50. Download as CSV

Medicare payments per case for Level 6 Musculoskeletal Procedures by hospital, 2024
HospitalCasesAverage paymentvs national averageMedicare paidBilled charge
Palomar Medical Center PowayPoway, CA · CCN 05063642$15,780About average$14,146$87,516
Clovis Community Medical CenterClovis, CA · CCN 05049216$20,32217% above the national average$18,686$101,905
Adventist Health Sierra VistaSan Luis Obispo, CA · CCN 05050612$21,08721% above the national average$19,455$213,655
Los Robles Hospital & Medical CenterThousand Oaks, CA · CCN 05054930$21,44523% above the national average$19,805$330,038
San Antonio Regional HospitalUpland, CA · CCN 05009916$21,52524% above the national average$19,893$98,558
Saint John's Health CenterSanta Monica, CA · CCN 05029042$21,88726% above the national average$20,255$82,951
Patients' Hospital Of ReddingRedding, CA · CCN 05069724$21,94226% above the national average$20,342$128,816
MemorialCare Long Beach Medical CenterLong Beach, CA · CCN 05048526$22,03527% above the national average$20,403$84,765
Community Memorial Hospital - VenturaVentura, CA · CCN 05039477$22,06627% above the national average$20,434$82,254
Cedar-Sinai Marina Del Rey HospitalMarina Del Rey, CA · CCN 05074032$22,19628% above the national average$20,564$128,095
Sutter Surgical Hospital - North ValleyYuba City, CA · CCN 050766 · +$1,206 outlier payments per case27$22,22028% above the national average$20,588$105,388
Huntington HospitalPasadena, CA · CCN 05043835$22,24528% above the national average$20,613$123,149
Goleta Valley Cottage HospitalSanta Barbara, CA · CCN 05035765$22,24928% above the national average$20,626$99,852
Uci Health-OrangeOrange, CA · CCN 05034839$22,31028% above the national average$20,675$115,752
Santa Monica - UCLA Medical Center & Orthopaedic HospitalSanta Monica, CA · CCN 05011282$22,33428% above the national average$20,702$83,926
Doctors Medical CenterModesto, CA · CCN 05046442$22,34628% above the national average$20,703$191,353
Mercy Medical CenterMerced, CA · CCN 05044436$22,34728% above the national average$20,734$66,791
Fresno Surgical HospitalFresno, CA · CCN 050708101$22,43129% above the national average$20,799$52,639
Grossmont HospitalLa Mesa, CA · CCN 05002676$22,57430% above the national average$20,940$119,855
Cedars-Sinai Medical CenterLos Angeles, CA · CCN 050625113$22,66430% above the national average$21,031$267,265
Scripps Green HospitalLa Jolla, CA · CCN 050424119$22,67330% above the national average$21,041$147,109
Bakersfield Memorial HospitalBakersfield, CA · CCN 05003631$22,82231% above the national average$21,190$143,521
Adventist Health BakersfieldBakersfield, CA · CCN 05045534$22,85131% above the national average$21,219$170,317
Adventist Health Twin CitiesTempleton, CA · CCN 05063320$22,85131% above the national average$21,219$188,046
Community Regional Medical CenterFresno, CA · CCN 05006018$22,85131% above the national average$21,219$119,787
Enloe HealthChico, CA · CCN 05003926$22,85131% above the national average$21,219$109,872
Kaweah Health Medical CenterVisalia, CA · CCN 05005769$22,85131% above the national average$21,219$49,320
Loma Linda University Medical CenterLoma Linda, CA · CCN 05032748$22,85131% above the national average$21,219$128,188
Marian Regional Medical CenterSanta Maria, CA · CCN 05010740$22,85131% above the national average$21,219$125,383
MemorialCare Saddleback Medical CenterLaguna Hills, CA · CCN 05060322$22,85131% above the national average$21,219$110,235
Memorial Medical CenterModesto, CA · CCN 05055733$22,85131% above the national average$21,219$98,508
Mercy Medical Center ReddingRedding, CA · CCN 05028050$22,85131% above the national average$21,219$84,551
Northridge Hospital Medical CenterNorthridge, CA · CCN 05011632$22,85131% above the national average$21,219$145,913
Providence Cedars Sinai Tarzana Medical CenterTarzana, CA · CCN 05076128$22,85131% above the national average$21,219$116,678
Providence Little Company Of Mary Medical Center TorranceTorrance, CA · CCN 05035316$22,85131% above the national average$21,219$115,483
Providence Saint Joseph Medical CenterBurbank, CA · CCN 05023533$22,85131% above the national average$21,219$129,353
Saint Agnes Medical CenterFresno, CA · CCN 05009321$22,85131% above the national average$21,219$109,011
Scripps Memorial Hospital - EncinitasEncinitas, CA · CCN 05050327$22,85131% above the national average$21,219$187,931
Sharp Memorial HospitalSan Diego, CA · CCN 05010032$22,85131% above the national average$21,219$130,020
Shasta Regional Medical CenterRedding, CA · CCN 05076425$22,85131% above the national average$21,219$149,531
Southwest Healthcare Rancho Springs HospitalMurrieta, CA · CCN 05070125$22,85131% above the national average$21,219$97,141
St Bernardine Medical CenterSan Bernardino, CA · CCN 05012916$22,85131% above the national average$21,219$88,462
Temecula Valley HospitalTemecula, CA · CCN 05077515$22,85131% above the national average$21,219$111,576
Tri-City Medical CenterOceanside, CA · CCN 05012823$22,85131% above the national average$21,219$101,126
UCLA West Valley Medical CenterWest Hills, CA · CCN 05048115$22,85131% above the national average$21,219$301,746
Adventist Health HanfordHanford, CA · CCN 05012113$22,85131% above the national average$21,219$117,383
French Hospital Medical CenterSan Luis Obispo, CA · CCN 050232107$22,85131% above the national average$21,219$127,114
MemorialCare Orange Coast Medical CenterFountain Valley, CA · CCN 05067813$22,85131% above the national average$21,219$117,509
PIH Health Hospital-WhittierWhittier, CA · CCN 05016911$22,85131% above the national average$21,219$99,967
Providence Holy Cross Medical CenterMission Hills, CA · CCN 05027813$22,85131% above the national average$21,219$111,927

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 careAverage paymentAverage 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
StateHospitalsCasesAverage paymentTypical range
Vermont3119$8,999$8,453–$10,624
Alabama251,210$15,164$14,755–$15,349
Utah231,080$15,193$16,244–$16,659
Tennessee332,084$15,325$15,130–$15,866
Mississippi14683$15,430$15,026–$15,570
Louisiana301,108$15,576$15,464–$15,754
West Virginia12558$15,715$14,973–$15,721
Oklahoma301,351$15,834$15,611–$16,023
Arkansas211,202$15,872$15,523–$16,345
South Carolina301,929$15,906$15,619–$16,100
Ohio733,030$15,978$15,826–$16,279
Kentucky221,410$16,042$15,742–$16,096
Kansas231,240$16,065$15,767–$16,241
Iowa201,326$16,087$15,847–$16,340
Missouri351,775$16,103$15,799–$16,551
Virginia412,439$16,328$15,963–$17,432
Texas1275,228$16,373$16,124–$16,789
Michigan441,746$16,380$15,785–$17,123
Georgia421,898$16,409$15,899–$17,257
North Carolina452,608$16,492$16,184–$16,710
Indiana472,034$16,575$16,509–$16,797
Florida865,085$16,629$16,634–$16,845
Nebraska161,011$16,771$16,741–$16,936
Wisconsin381,368$16,885$16,647–$17,067
Idaho13741$16,900$16,735–$17,428
New Mexico9300$17,126$15,882–$17,343
Maine7292$17,280$16,837–$17,471
Pennsylvania653,133$17,344$16,610–$17,938
Illinois562,463$17,391$17,185–$17,654
North Dakota6437$17,467$17,235–$18,360
South Dakota10790$17,472$17,281–$18,289
Montana9516$17,606$17,193–$18,232
Colorado372,121$17,744$17,468–$17,701
Minnesota271,383$18,117$17,504–$18,536
Wyoming8289$18,154$18,579–$18,669
New Hampshire11403$18,184$17,654–$18,332
Arizona372,369$18,231$17,996–$18,131
Delaware5457$18,546$18,654–$18,654
Rhode Island3157$18,657$18,634–$18,765
District of Columbia4199$18,848$18,878–$19,023
Washington331,628$19,062$18,661–$19,156
Alaska3180$19,345$18,819–$19,653
New Jersey281,653$19,847$19,222–$20,663
Oregon20929$19,883$19,066–$19,507
Massachusetts341,711$19,887$19,966–$19,966
New York511,970$19,922$19,552–$20,841
Nevada9617$19,943$19,802–$19,910
Connecticut16778$20,733$20,681–$20,925
Hawaii370$21,247$21,066–$22,304
California974,332$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.