Level 1 Breast/Lymphatic Surgery and Related Procedures
What 2,382 hospitals in the U.S. charged and were paid for level 1 breast/lymphatic surgery and related procedures (APC 5091), from 2024 Medicare claims.
Average charge
$27,785
Hospital list price billed
Average allowed
$3,688
Medicare's payment + patient's share
Medicare paid
$2,930
Average per service
Volume
46,352
Medicare services
Hospitals in the U.S. billed an average of $27,785 for level 1 breast/lymphatic surgery and related procedures, about 7.5 times the average medicare-allowed amount of $3,688.
These are averages for patients with original (fee-for-service) Medicare. Private insurance pays different, negotiated prices, and what you owe depends on your plan's deductible and coinsurance. Use these figures to compare hospitals, not as a quote.
Paid $3,688Billed $27,785
About 13¢ was paid for every $1 hospitals in the U.S. billed for this service.
Lowest and highest allowed amounts
Among hospitals with at least 20 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Lewistown HospitalLewistown, PA | $1,819 |
|---|---|
| Fletcher Allen Hospital of VermontBurlington, VT | $1,819 |
| UPMC MemorialYork, PA | $1,838 |
| Baptist Memorial Hospital HuntingdonHuntingdon, TN | $1,872 |
| Marietta Memorial HospitalMarietta, OH | $2,107 |
| Lee Memorial HospitalFort Myers, FL | $2,532 |
| Piedmont Healthcare SystemRock Hill, SC | $2,595 |
| Gettysburg HospitalGettysburg, PA | $2,678 |
| Brookwood Medical CenterBirmingham, AL | $2,798 |
| Memorial Hospital at GulfportGulfport, MS | $2,817 |
Highest
| Peninsula Medical CenterBurlingame, CA | $5,449 |
|---|---|
| California Pacific Medical Ctr-Davies Campus HospSan Francisco, CA | $5,404 |
| Good Samaritan HospitalSan Jose, CA | $5,368 |
| UCSF Medical CenterSan Francisco, CA | $5,368 |
| El Camino HospitalMountain View, CA | $5,368 |
| Community Hospital of the Monterey PeninsulaMonterey, CA | $5,368 |
| Stanford Health Care Tri-ValleyPleasanton, CA | $5,368 |
| Santa Rosa Memorial HospitalSanta Rosa, CA | $5,338 |
| Stanford HospitalPalo Alto, CA | $5,328 |
| Marinhealth Medical CenterGreenbrae, CA | $5,323 |
Level 1 Breast/Lymphatic Surgery and Related Procedures cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg allowed | Range |
|---|---|---|---|---|
| Alabama | 53 | $29,454 | $3,114 | $2,798 – $3,387 |
| Alaska | 5 | $32,223 | $3,957 | $3,710 – $4,214 |
| Arizona | 40 | $28,375 | $3,717 | $3,558 – $3,981 |
| Arkansas | 28 | $15,597 | $3,247 | $3,065 – $3,501 |
| California | 200 | $42,573 | $4,851 | $4,313 – $5,449 |
| Colorado | 45 | $31,417 | $3,624 | $3,506 – $3,886 |
| Connecticut | 25 | $22,347 | $4,260 | $4,027 – $4,294 |
| Delaware | 5 | $18,193 | $3,811 | $3,796 – $3,834 |
| Florida | 147 | $39,262 | $3,379 | $2,532 – $3,698 |
| Georgia | 74 | $28,890 | $3,368 | $3,007 – $3,538 |
| Hawaii | 11 | $19,024 | $4,353 | $4,303 – $4,384 |
| Idaho | 15 | $21,662 | $3,536 | $3,392 – $3,689 |
| Illinois | 94 | $27,281 | $3,603 | $3,353 – $3,773 |
| Indiana | 66 | $27,957 | $3,463 | $3,244 – $3,639 |
| Iowa | 29 | $23,068 | $3,338 | $3,222 – $3,695 |
| Kansas | 30 | $20,625 | $3,311 | $3,218 – $3,502 |
| Kentucky | 50 | $22,953 | $3,266 | $3,078 – $3,527 |
| Louisiana | 56 | $24,707 | $3,169 | $3,023 – $3,304 |
| Maine | 15 | $19,044 | $3,457 | $3,321 – $3,742 |
| Massachusetts | 51 | $17,534 | $4,080 | $3,938 – $4,299 |
| Michigan | 76 | $19,585 | $3,370 | $3,047 – $3,584 |
| Minnesota | 42 | $18,020 | $3,743 | $3,548 – $3,907 |
| Mississippi | 36 | $25,277 | $3,173 | $2,817 – $3,418 |
| Missouri | 56 | $19,804 | $3,289 | $2,507 – $3,633 |
| Montana | 10 | $15,666 | $3,630 | $3,540 – $3,827 |
| Nebraska | 20 | $20,976 | $3,425 | $3,170 – $3,532 |
| Nevada | 15 | $46,544 | $3,997 | $3,731 – $4,093 |
| New Hampshire | 13 | $26,172 | $3,744 | $3,537 – $3,874 |
| New Jersey | 55 | $24,781 | $4,070 | $3,581 – $4,338 |
| New Mexico | 16 | $31,679 | $3,419 | $3,246 – $3,860 |
| New York | 107 | $27,126 | $4,207 | $3,378 – $4,338 |
| North Carolina | 70 | $20,657 | $3,383 | $2,844 – $3,557 |
| North Dakota | 6 | $12,395 | $3,615 | $3,574 – $3,827 |
| Ohio | 102 | $25,939 | $3,250 | $1,526 – $3,573 |
| Oklahoma | 45 | $25,919 | $3,261 | $3,085 – $3,539 |
| Oregon | 28 | $19,686 | $4,027 | $3,761 – $4,628 |
| Pennsylvania | 109 | $32,703 | $3,508 | $1,819 – $4,017 |
| Rhode Island | 8 | $13,083 | $3,843 | $3,615 – $3,868 |
| South Carolina | 42 | $29,883 | $3,257 | $2,595 – $3,601 |
| South Dakota | 13 | $19,731 | $3,563 | $3,495 – $3,827 |
| Tennessee | 63 | $22,175 | $3,183 | $1,872 – $3,496 |
| Texas | 190 | $31,340 | $3,405 | $3,196 – $3,558 |
| Utah | 26 | $14,929 | $3,416 | $3,167 – $3,657 |
| Vermont | 6 | $12,725 | $1,751 | $1,145 – $2,716 |
| Virginia | 60 | $28,803 | $3,395 | $3,032 – $3,748 |
| Washington | 41 | $26,581 | $3,892 | $3,696 – $4,097 |
| West Virginia | 20 | $21,388 | $3,207 | $3,031 – $3,632 |
| Wisconsin | 54 | $22,684 | $3,529 | $3,281 – $3,653 |
| Wyoming | 9 | $19,083 | $3,731 | $3,537 – $3,827 |
Hospitals that treat the most Medicare patients for this
| Hospital | Services | Avg charge | Avg allowed |
|---|---|---|---|
| Mem Sloan-Kettering Cancer CtrNew York, NY | 748 | $27,868 | $4,303 |
| NYU Hospitals CenterNew York, NY | 433 | $43,928 | $4,264 |
| New York-Presbyterian HospitalNew York, NY | 341 | $24,937 | $4,317 |
| Massachusetts General HospitalBoston, MA | 333 | $26,766 | $4,074 |
| Univ of Tx M D Anderson CtrHouston, TX | 293 | $21,306 | $3,515 |
| H Lee Moffitt Cancer CenterTampa, FL | 289 | $21,920 | $3,443 |
| Faulkner HospitalBoston, MA | 281 | $16,648 | $4,082 |
| Stanford HospitalPalo Alto, CA | 217 | $94,623 | $5,328 |
| Lee Memorial HospitalFort Myers, FL | 207 | $40,934 | $2,532 |
| Eisenhower Memorial HospitalRancho Mirage, CA | 200 | $26,941 | $4,651 |
| Cedars-Sinai Medical CenterLos Angeles, CA | 200 | $81,751 | $4,630 |
| Cleveland Clinic - Main CampusCleveland, OH | 200 | $22,095 | $3,233 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | 193 | $25,645 | $3,894 |
| Sarasota Memorial HospitalSarasota, FL | 190 | $28,677 | $3,453 |
| Evanston HospitalEvanston, IL | 186 | $16,763 | $3,548 |
Questions
How much does level 1 breast/lymphatic surgery and related procedures cost in the U.S.?
In 2024 Medicare data, level 1 breast/lymphatic surgery and related procedures (APC 5091) at 2,382 hospitals in the U.S. was billed at $27,785 on average, while the average medicare-allowed amount was $3,688, of which Medicare paid $2,930. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for level 1 breast/lymphatic surgery and related procedures?
Among states with at least three hospitals reporting, the average medicare-allowed amount was highest in California ($4,851), Hawaii ($4,353), Connecticut ($4,260) and lowest in Vermont ($1,751), Alabama ($3,114), Louisiana ($3,169).
Why are hospital charges so much higher than payments?
Charges are a hospital's list prices. Medicare pays fixed rates set in advance, and private insurers negotiate their own discounts, so almost nobody pays the full charge. For this service in the U.S., average charges were 7.5 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.
Source: CMS, Medicare Outpatient Hospitals by Provider and Service, 2024. The allowed amount is Medicare's payment plus the patient's coinsurance. CMS omits hospitals with fewer than 11 services for privacy. About the data.