Level 1 Breast/Lymphatic Surgery and Related Procedures in Massachusetts
What 51 hospitals in Massachusetts charged and were paid for level 1 breast/lymphatic surgery and related procedures (APC 5091), from 2024 Medicare claims.
Average charge
$17,534
Hospital list price billed
Average allowed
$4,080
Medicare's payment + patient's share
Medicare paid
$3,247
Average per service
State rank
#45 of 49
1 = lowest average payment
Hospitals in Massachusetts billed an average of $17,534 for level 1 breast/lymphatic surgery and related procedures, about 4.3 times the average medicare-allowed amount of $4,080. That payment is 11% above the U.S. average 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 $4,080Billed $17,534
About 23¢ was paid for every $1 hospitals in Massachusetts billed for this service.
Massachusetts hospitals: level 1 breast/lymphatic surgery and related procedures
Every Massachusetts hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Massachusetts General HospitalBoston | 333 | $26,766 | $4,074 | $3,242 |
| Faulkner HospitalBoston | 281 | $16,648 | $4,082 | $3,250 |
| Brigham and Women's HosptialBoston | 123 | $37,674 | $4,094 | $3,262 |
| South Shore HospitalSouth Weymouth | 114 | $8,892 | $4,011 | $3,179 |
| Umass Memorial Medical Center INCWorcester | 95 | $17,597 | $4,059 | $3,227 |
| Cape Cod HospitalHyannis | 90 | $16,700 | $4,094 | $3,262 |
| Lahey Clinic HospitalBurlington | 82 | $10,531 | $4,094 | $3,262 |
| Beth Israel Deaconess Hospital - NeedhamNeedham | 77 | $8,003 | $4,094 | $3,262 |
| Baystate Medical CenterSpringfield | 76 | $12,077 | $4,094 | $3,262 |
| Newton-Wellesley HospitalNewton Lower Falls | 73 | $15,961 | $4,094 | $3,261 |
| Beth Israel Deaconess Medical CenterBoston | 67 | $15,690 | $4,094 | $3,262 |
| Berkshire Medical Center INCPittsfield | 63 | $20,268 | $4,299 | $3,425 |
| Winchester HospitalWinchester | 62 | $10,381 | $3,975 | $3,156 |
| Mount Auburn HospitalCambridge | 55 | $12,037 | $4,094 | $3,262 |
| Southcoast Hospital Group, INCFall River | 54 | $19,136 | $4,094 | $3,262 |
| Lowell General HospitalLowell | 45 | $13,679 | $4,021 | $3,189 |
| Beverly Hospital CorporationBeverly | 44 | $9,647 | $4,020 | $3,187 |
| Noble HospitalWestfield | 43 | $9,787 | $4,094 | $3,262 |
| Boston Medical Center CorporationBoston | 42 | $11,118 | $4,094 | $3,260 |
| Cooley Dickinson Hospital Inc,TheNorthampton | 41 | $16,498 | $4,094 | $3,257 |
| Falmouth HospitalFalmouth | 31 | $18,972 | $4,094 | $3,262 |
| St Vincent HospitalWorcester | 31 | $47,180 | $4,094 | $3,262 |
| Melrosewakefield HealthcareMelrose | 28 | $17,083 | $3,977 | $3,145 |
| Milford Regional Medical CenterMilford | 28 | $8,232 | $4,076 | $3,244 |
| Saint Anne's Hospital, a Caritas Family HospitalFall River | 27 | $10,656 | $4,094 | $3,259 |
| Beth Israel Deaconess Hospital PlymouthPlymouth | 27 | $12,503 | $4,094 | $3,262 |
| Anna Jaques HospitalNewburyport | 26 | $10,835 | $4,094 | $3,262 |
| Emerson HospitalConcord | 26 | $12,252 | $4,094 | $3,262 |
| Brockton HospitalBrockton | 22 | $10,798 | $4,094 | $3,262 |
| Baystate Franklin Medical CenterGreenfield | 21 | $13,542 | $3,938 | $3,106 |
| Massachusetts Eye and Ear InfirmaryBoston | 21 | $18,804 | $4,094 | $3,262 |
| Mercy Medical CenterSpringfield | 20 | $9,257 | $4,094 | $3,261 |
| Holy Family Hospital, a Caritas Family HospitalMethuen | 20 | $11,646 | $4,094 | $3,262 |
| Tufts Medical CenterBoston | 18 | $21,983 | $4,094 | $3,262 |
| Sturdy Memorial HospitalAttleboro | 14 | $11,209 | $4,094 | $3,262 |
| Lawrence General HospitalLawrence | 13 | $12,340 | $4,094 | $3,262 |
| Holyoke Medical CenterHolyoke | 12 | $12,021 | $4,094 | $3,262 |
| Good Samaritan Medical Center, a Caritas Family HoBrockton | 12 | $12,522 | $4,094 | $3,260 |
| Healthalliance Hospitals, INCLeominster | – | – | – | – |
| Cambridge Health AllianceCambridge | – | – | – | – |
| Carney HospitalDorchester | – | – | – | – |
| Harrington Memorial HospitalSouthbridge | – | – | – | – |
| Wing Memorial Hospital and Medical CenterPalmer | – | – | – | – |
| Union HospitalLynn | – | – | – | – |
| Boston Medical Center-BrightonBrighton | – | – | – | – |
| Marlborough HospitalMarlborough | – | – | – | – |
| Morton Hospital & Medical CenterTaunton | – | – | – | – |
| New England Baptist HospitalBoston | – | – | – | – |
| Heywood HospitalGardner | – | – | – | – |
| Nashoba Valley Medical CenterAyer | – | – | – | – |
| Metrowest Medical CenterFramingham | – | – | – | – |
Lowest and highest allowed amounts in Massachusetts
Among hospitals with at least 11 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Baystate Franklin Medical CenterGreenfield, MA | $3,938 |
|---|---|
| Winchester HospitalWinchester, MA | $3,975 |
| Melrosewakefield HealthcareMelrose, MA | $3,977 |
| South Shore HospitalSouth Weymouth, MA | $4,011 |
| Beverly Hospital CorporationBeverly, MA | $4,020 |
Highest
| Berkshire Medical Center INCPittsfield, MA | $4,299 |
|---|---|
| Cooley Dickinson Hospital Inc,TheNorthampton, MA | $4,094 |
| Saint Anne's Hospital, a Caritas Family HospitalFall River, MA | $4,094 |
| Boston Medical Center CorporationBoston, MA | $4,094 |
| Newton-Wellesley HospitalNewton Lower Falls, MA | $4,094 |
Level 1 Breast/Lymphatic Surgery and Related Procedures in other states
Questions
How much does level 1 breast/lymphatic surgery and related procedures cost in Massachusetts?
In 2024 Medicare data, level 1 breast/lymphatic surgery and related procedures (APC 5091) at 51 hospitals in Massachusetts was billed at $17,534 on average, while the average medicare-allowed amount was $4,080, of which Medicare paid $3,247. Your own cost depends on your insurance, deductible and the hospital.
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 Massachusetts, average charges were 4.3 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.