CostGrade

Level 5 Musculoskeletal Procedures — what U.S. hospitals charge

APC 5115 · Hospital outpatient visit · 2,213 U.S. hospitals publish a price

Cheapest quarter

under $44,833

Typical charge

$62,465

Dearest quarter

over $89,398

Actually paid

$12,348

The middle U.S. hospital bills $62,465 for Level 5 Musculoskeletal Procedures. The dearest hospitals charge about 3.5x what the cheapest do for the same coded work. Medicare actually paid about $12,348 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 5 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 8 $30,111 $24,168 – $36,703
Massachusetts 43 $33,701 $15,824 – $114,847
North Dakota 6 $36,418 $35,206 – $53,649
Minnesota 42 $38,890 $26,924 – $54,941
Vermont 6 $40,758 $31,353 – $42,729
New York 91 $42,291 $16,475 – $205,162
Michigan 73 $44,721 $16,813 – $120,010
Oregon 29 $44,769 $32,586 – $82,868
Utah 32 $45,351 $33,674 – $129,888
Iowa 29 $45,361 $28,694 – $87,573
Montana 10 $45,475 $26,859 – $67,710
Mississippi 25 $45,655 $20,820 – $212,181
Arkansas 28 $46,001 $19,488 – $109,473
Wyoming 10 $46,031 $37,289 – $130,025
South Dakota 13 $46,156 $29,135 – $60,504
Idaho 15 $46,591 $37,407 – $107,613
Connecticut 23 $47,195 $30,999 – $84,868
Delaware 6 $47,646 $31,160 – $87,921
Missouri 53 $48,954 $28,867 – $246,396
Hawaii 9 $49,057 $39,477 – $67,099
Wisconsin 56 $49,518 $24,979 – $86,455
Nebraska 21 $49,549 $33,172 – $96,117
Maine 14 $49,972 $41,888 – $77,015
Kansas 34 $52,023 $21,259 – $165,121
New Jersey 43 $53,351 $30,372 – $209,783
Alabama 36 $54,603 $19,606 – $213,693
Louisiana 44 $54,644 $19,260 – $138,736
West Virginia 19 $55,276 $23,849 – $83,304
Ohio 104 $55,648 $29,322 – $105,739
Pennsylvania 105 $56,798 $26,127 – $149,904
North Carolina 65 $59,683 $26,253 – $117,096
Virginia 55 $60,336 $31,906 – $290,759
New Hampshire 11 $62,826 $34,477 – $202,404
Oklahoma 42 $65,522 $30,823 – $210,349
Tennessee 47 $67,465 $33,488 – $183,569
Kentucky 42 $68,310 $32,070 – $185,353
Illinois 82 $69,039 $31,776 – $188,863
South Carolina 43 $74,749 $31,950 – $200,226
Texas 188 $75,102 $27,776 – $374,755
Washington 43 $75,665 $31,644 – $117,374
Colorado 47 $76,075 $46,640 – $240,882
Indiana 64 $76,781 $32,093 – $183,799
Georgia 71 $77,289 $37,977 – $138,776
Alaska 6 $78,549 $48,355 – $149,516
District of Columbia 4 $78,580 $43,170 – $119,751
New Mexico 16 $82,829 $32,899 – $264,902
Arizona 47 $88,490 $33,909 – $215,438
California 164 $93,233 $32,508 – $293,615
Florida 133 $113,495 $29,518 – $227,511
Nevada 16 $138,161 $45,720 – $186,778

Where Level 5 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
Cambridge Health Alliance

Cambridge, MA

$15,824 $13,750
Bertrand Chaffee Hospital

Springville, NY

$16,475 $13,930
Tawas St Joseph Hospital

Tawas City, MI

$16,813 $12,341
Mount Auburn Hospital

Cambridge, MA

$18,235 $13,915
West Calcasieu Cameron Hospital

Sulphur, LA

$19,260 $11,044
St Bernards Medical Center

Jonesboro, AR

$19,488 $11,021
North Baldwin Infirmary

Bay Minette, AL

$19,606 $10,913
Northeast Hospital Corporation

Beverly, MA

$20,211 $13,913
Baptist Memorial Hospital-Oktibbeha County

Starkville, MS

$20,820 $10,737
Kansas Medical Center Llc

Andover, KS

$21,259 $11,223
South Shore Hospital

South Weymouth, MA

$21,439 $14,030
Lahey Hospital & Medical Center, Burlington

Burlington, MA

$22,587 $13,923

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
Woodland Heights Medical Center

Lufkin, TX

$374,755 $11,406
Medical City Denton

Denton, TX

$351,894 $11,866
Medical Center Of Mckinney

Mckinney, TX

$295,710 $11,737
Good Samaritan Hospital

San Jose, CA

$293,615 $18,234
Henrico Doctors' Hospital

Richmond, VA

$290,759 $11,330
Cjw Medical Center

Richmond, VA

$290,537 $11,256
John Randolph Medical Center

Hopewell, VA

$287,754 $11,133
Medical City Las Colinas

Irving, TX

$271,438 $11,828
Hca Houston Healthcare Northwest

Houston, TX

$268,548 $12,187
Christus Southern New Mexico

Alamogordo, NM

$264,902 $12,258
Northbay Medical Center

Fairfield, CA

$256,656 $18,892
Medical City Plano

Plano, TX

$255,934 $11,754

Questions people ask

What do U.S. hospitals charge for Level 5 Musculoskeletal Procedures?

Across 2,213 U.S. hospitals, the middle charge for Level 5 Musculoskeletal Procedures is $62,465. Half of hospitals charge less than that and half charge more. The cheapest quarter charge under $44,833 and the dearest quarter over $89,398.

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 5 Musculoskeletal Procedures, the hospitals in the dearest tenth charge about 3.5x 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. $12,348 is roughly what Medicare actually paid per case, against an average charge of $72,739. 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 5115: “Level 5 Musculoskeletal Procedures”. An APC covers one outpatient visit for that level of service — you go home the same day.