Level 4 Musculoskeletal Procedures — what U.S. hospitals charge
APC 5114 · Hospital outpatient visit · 2,236 U.S. hospitals publish a price
Cheapest quarter
under $29,596
Typical charge
$39,867
Dearest quarter
over $59,654
Actually paid
$6,714
The middle U.S. hospital bills $39,867 for Level 4 Musculoskeletal Procedures. The dearest hospitals charge about 3.7x what the cheapest do for the same coded work. Medicare actually paid about $6,714 per case.
These are charges, not quotes. What you pay depends on your insurance and your own case. The figures matter because the charge is where an uninsured or out-of-network bill starts.
Level 4 Musculoskeletal Procedures cost by state
The middle charge in each state where at least three hospitals publish a price, cheapest first.
| State | Hospitals | Typical charge | Range |
|---|---|---|---|
| Rhode Island | 7 | $17,354 | $14,602 – $18,927 |
| Massachusetts | 49 | $21,301 | $8,560 – $67,831 |
| North Dakota | 6 | $23,926 | $21,619 – $26,644 |
| Vermont | 6 | $25,516 | $21,912 – $28,167 |
| Minnesota | 41 | $26,056 | $17,030 – $54,209 |
| Arkansas | 27 | $26,308 | $12,894 – $71,190 |
| Utah | 31 | $26,735 | $14,891 – $79,280 |
| Mississippi | 27 | $28,107 | $13,744 – $141,959 |
| New York | 93 | $29,162 | $12,153 – $109,387 |
| Kansas | 37 | $29,441 | $11,539 – $94,592 |
| Michigan | 73 | $29,747 | $13,244 – $90,512 |
| Idaho | 15 | $29,863 | $22,529 – $67,807 |
| South Dakota | 13 | $30,382 | $17,883 – $43,367 |
| Montana | 9 | $30,638 | $14,441 – $47,637 |
| Hawaii | 10 | $30,794 | $13,924 – $46,764 |
| Wisconsin | 54 | $31,417 | $19,018 – $58,145 |
| Nebraska | 23 | $31,895 | $17,846 – $53,090 |
| Iowa | 26 | $31,929 | $21,809 – $64,265 |
| Connecticut | 21 | $32,122 | $20,788 – $60,530 |
| Oregon | 29 | $32,347 | $23,559 – $59,954 |
| Maine | 13 | $32,660 | $25,999 – $47,454 |
| Missouri | 54 | $32,713 | $17,978 – $132,449 |
| Delaware | 6 | $33,119 | $21,764 – $62,159 |
| Alabama | 40 | $33,221 | $11,701 – $149,657 |
| West Virginia | 19 | $34,776 | $14,609 – $60,732 |
| Wyoming | 10 | $35,251 | $23,332 – $74,878 |
| Ohio | 97 | $35,717 | $19,597 – $74,797 |
| North Carolina | 65 | $36,678 | $13,341 – $66,026 |
| Kentucky | 38 | $36,859 | $21,424 – $72,078 |
| New Hampshire | 12 | $36,932 | $24,461 – $120,789 |
| Louisiana | 44 | $38,663 | $17,139 – $129,565 |
| Pennsylvania | 105 | $38,727 | $17,479 – $101,451 |
| Virginia | 56 | $39,271 | $19,229 – $212,110 |
| New Jersey | 50 | $39,560 | $17,742 – $129,769 |
| Oklahoma | 47 | $40,430 | $14,729 – $114,099 |
| Alaska | 6 | $42,600 | $26,390 – $100,949 |
| Illinois | 83 | $43,485 | $18,511 – $105,082 |
| Tennessee | 51 | $45,066 | $16,144 – $116,889 |
| District of Columbia | 4 | $45,969 | $35,139 – $84,063 |
| South Carolina | 42 | $47,284 | $25,998 – $116,620 |
| Washington | 43 | $47,286 | $21,548 – $98,497 |
| Indiana | 65 | $47,604 | $23,562 – $138,576 |
| Texas | 188 | $50,968 | $12,463 – $242,345 |
| Colorado | 46 | $51,153 | $20,466 – $165,494 |
| New Mexico | 17 | $53,940 | $19,394 – $114,994 |
| Georgia | 73 | $55,874 | $21,303 – $110,268 |
| Arizona | 46 | $57,005 | $24,050 – $157,950 |
| California | 170 | $60,112 | $20,636 – $208,179 |
| Florida | 131 | $78,217 | $27,338 – $197,714 |
| Nevada | 18 | $86,958 | $32,429 – $117,913 |
Where Level 4 Musculoskeletal Procedures is charged least
Hospitals that performed it at least eleven times, so a single case cannot set the figure.
| Hospital | Charged | Actually paid |
|---|---|---|
|
Mount Auburn Hospital
Cambridge, MA |
$8,560 | $7,621 |
|
Cambridge Health Alliance
Cambridge, MA |
$10,867 | $7,683 |
|
Kansas Medical Center Llc
Andover, KS |
$11,539 | $6,108 |
|
North Baldwin Infirmary
Bay Minette, AL |
$11,701 | $5,938 |
|
South Shore Hospital
South Weymouth, MA |
$11,948 | $7,588 |
|
The East Alabama Healthcare Authority
Opelika, AL |
$12,060 | $6,253 |
|
Geneva General Hospital
Geneva, NY |
$12,153 | $7,585 |
|
Beth Israel Deaconess Hospital - Milton
Milton, MA |
$12,278 | $7,486 |
|
Kell West Regional Hospital
Wichita Falls, TX |
$12,463 | $6,115 |
|
St Joseph's Medical Center
Yonkers, NY |
$12,592 | $8,140 |
|
Signature Healthcare Brockton Hospital
Brockton, MA |
$12,595 | $7,683 |
|
Canton-Potsdam Hospital
Potsdam, NY |
$12,811 | $8,123 |
Where it is charged most
Hospitals that performed it at least eleven times, so a single case cannot set the figure.
| Hospital | Charged | Actually paid |
|---|---|---|
|
The Woodlands Specialty Hospital
Spring, TX |
$242,345 | $6,505 |
|
South Texas Health System
Edinburg, TX |
$237,371 | $6,208 |
|
Hca Houston Healthcare Tomball
Tomball, TX |
$230,724 | $6,634 |
|
John Randolph Medical Center
Hopewell, VA |
$212,110 | $6,225 |
|
Northbay Medical Center
Fairfield, CA |
$208,179 | $10,092 |
|
Medical City Arlington
Arlington, TX |
$206,594 | $6,459 |
|
Ucla West Valley Medical Center
West Hills, CA |
$201,725 | $8,793 |
|
St Lucie Medical Center
Port Saint Lucie, FL |
$197,714 | $6,128 |
|
Good Samaritan Hospital
San Jose, CA |
$177,405 | $10,066 |
|
Medical City Las Colinas
Irving, TX |
$177,001 | $6,438 |
|
Los Robles Hospital & Medical Center
Thousand Oaks, CA |
$176,429 | $8,689 |
|
Emanuel Medical Center
Turlock, CA |
$172,379 | $8,824 |
Questions people ask
What do U.S. hospitals charge for Level 4 Musculoskeletal Procedures?
Across 2,236 U.S. hospitals, the middle charge for Level 4 Musculoskeletal Procedures is $39,867. Half of hospitals charge less than that and half charge more. The cheapest quarter charge under $29,596 and the dearest quarter over $59,654.
Why do hospitals charge such different amounts for the same procedure?
Because a hospital charge is a list price it sets itself, not a regulated rate. For Level 4 Musculoskeletal Procedures, the hospitals in the dearest tenth charge about 3.7x what the cheapest tenth charge for the same coded work. Insurers negotiate their own rates from those lists, which is why the charge and what is actually paid can be very far apart.
Is that what I would actually pay?
No. $6,714 is roughly what Medicare actually paid per case, against an average charge of $46,846. If you have insurance, your plan pays a negotiated rate and you pay your deductible and coinsurance. If you are uninsured or out of network, the hospital's charge is where your bill starts — which is why the gap matters. Ask for a written good-faith estimate before treatment.
What this code covers
CMS records this work as APC 5114: “Level 4 Musculoskeletal Procedures”. An APC covers one outpatient visit for that level of service — you go home the same day.