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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 Montana

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
Montana
Specific hospitals up to 10
Average payment across these 9 hospitals
$17,606National $17,392 · Montana $17,606
Median hospital
$17,434
Lowest to highest
$16,650–$18,495
Medicare procedures
516

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

Medicare payments per case for Level 6 Musculoskeletal Procedures by hospital, 2024
HospitalCasesAverage paymentvs national averageMedicare paidBilled charge
Billings Clinic HospitalBillings, MT · CCN 27000440$16,650About average$15,034$47,507
Community Medical CenterMissoula, MT · CCN 270023 · +$1,230 outlier payments per case65$17,191About average$15,559$76,503
St. Patrick HospitalMissoula, MT · CCN 270014131$17,193About average$15,554$44,365
Benefis Hospitals IncGreat Falls, MT · CCN 27001220$17,434About average$15,802$83,588
Intermountain Health St Vincent Regional HospitalBillings, MT · CCN 27004963$17,434About average$15,802$63,363
Great Falls Clinic HospitalGreat Falls, MT · CCN 27008623$17,434About average$15,798$74,206
Logan Health Medical CenterKalispell, MT · CCN 27005139$18,232About average$16,600$49,248
St Peters HealthHelena, MT · CCN 27000337$18,308About average$16,676$47,021
Bozeman Health Deaconess HospitalBozeman, MT · CCN 270057 · +$534 outlier payments per case98$18,495About average$16,863$63,756

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.