Level 1 Breast/Lymphatic Surgery and Related Procedures in Pennsylvania
What 109 hospitals in Pennsylvania charged and were paid for level 1 breast/lymphatic surgery and related procedures (APC 5091), from 2024 Medicare claims.
Average charge
$32,703
Hospital list price billed
Average allowed
$3,508
Medicare's payment + patient's share
Medicare paid
$2,791
Average per service
State rank
#26 of 49
1 = lowest average payment
Hospitals in Pennsylvania billed an average of $32,703 for level 1 breast/lymphatic surgery and related procedures, about 9.3 times the average medicare-allowed amount of $3,508. That payment is 5% below 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 $3,508Billed $32,703
About 11¢ was paid for every $1 hospitals in Pennsylvania billed for this service.
Pennsylvania hospitals: level 1 breast/lymphatic surgery and related procedures
Every Pennsylvania hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Hospital of the Univ of PaPhiladelphia | 166 | $58,046 | $3,465 | $2,761 |
| Lehigh Valley HospitalAllentown | 119 | $25,928 | $3,693 | $2,936 |
| Pennsylvania Hosp of the Univ of Pa Health SysPhiladelphia | 116 | $29,575 | $3,840 | $3,060 |
| Lancaster General HospitalLancaster | 96 | $24,385 | $3,546 | $2,825 |
| Fox Chase Cancer CenterPhiladelphia | 88 | $45,937 | $3,703 | $2,951 |
| Magee Womens Hospital of UPMC Health SystemPittsburgh | 82 | $26,938 | $2,923 | $2,321 |
| Thomas Jefferson University HospitalPhiladelphia | 64 | $31,173 | $3,533 | $2,815 |
| Geisinger Medical CenterDanville | 63 | $62,824 | $3,318 | $2,626 |
| Main Line Hospital Bryn Mawr CampusBryn Mawr | 60 | $18,756 | $3,677 | $2,922 |
| Milton S Hershey Medical CenterHershey | 60 | $41,724 | $3,558 | $2,833 |
| UPMC Pinnacle HospitalsHarrisburg | 57 | $22,680 | $3,416 | $2,718 |
| UPMC Presbyterian ShadysidePittsburgh | 57 | $56,627 | $3,404 | $2,713 |
| St Luke's Hospital BethlehemBethlehem | 56 | $47,105 | $3,718 | $2,962 |
| Chester County HospitalWest Chester | 49 | $24,384 | $3,677 | $2,929 |
| Albert Einstein Medical CenterPhiladelphia | 46 | $12,223 | $3,703 | $2,950 |
| Jefferson Einstein Montgomery HospitalEast Norriton | 46 | $13,002 | $3,576 | $2,846 |
| Main Line Hospital LankenauWynnewood | 45 | $20,496 | $3,677 | $2,930 |
| Main Line Hospital PaoliPaoli | 44 | $18,795 | $3,677 | $2,930 |
| Good Samaritan HospitalLebanon | 43 | $17,752 | $3,614 | $2,880 |
| Geisinger Wyoming Vly Med CtrWilkes-Barre | 42 | $59,486 | $3,048 | $2,415 |
| St Luke's Hospital - Anderson CampusEaston | 40 | $53,161 | $3,474 | $2,768 |
| York HospitalYork | 36 | $17,446 | $3,508 | $2,777 |
| Riddle Memorial HospitalMedia | 35 | $20,581 | $3,703 | $2,951 |
| Saint Vincent Health CenterErie | 33 | $43,510 | $4,017 | $3,201 |
| Holy Redeemer Hosp and Med CtrJenkintown | 32 | $13,633 | $3,576 | $2,849 |
| Ephrata Community HospitalEphrata | 32 | $22,997 | $3,476 | $2,769 |
| Crozer Chester Medical CenterChester | 31 | $43,334 | $3,663 | $2,905 |
| Williamsport Hospital & Medical CenterWilliamsport | 30 | $29,455 | $3,404 | $2,713 |
| Hamot Medical CenterErie | 30 | $35,854 | $4,017 | $3,201 |
| Phoenixville HospitalPhoenixville | 29 | $30,818 | $3,579 | $2,831 |
| Geisinger-Community Medical CenterScranton | 27 | $54,484 | $3,304 | $2,612 |
| West Penn HospitalPittsburgh | 27 | $26,299 | $3,404 | $2,713 |
| UPMC PassavantPittsburgh | 27 | $30,840 | $3,404 | $2,713 |
| Lehigh Valley Hospital - Dickson CityDickson City | 26 | $27,152 | $3,404 | $2,713 |
| Dubois Regional Medical CenterDubois | 25 | $12,480 | $3,439 | $2,716 |
| Jefferson Regional Medical CenterClairton | 25 | $21,306 | $3,404 | $2,713 |
| AHN Wexford HospitalWexford | 25 | $22,964 | $3,404 | $2,713 |
| Reading Hospital and Med CtrWest Reading | 24 | $23,580 | $3,483 | $2,775 |
| Grand View HospitalSellersville | 23 | $21,171 | $3,677 | $2,927 |
| Gettysburg HospitalGettysburg | 23 | $12,786 | $2,678 | $2,134 |
| UPMC MemorialYork | 22 | $18,415 | $1,838 | $1,454 |
| St Joseph Medical CenterReading | 21 | $47,855 | $3,476 | $2,769 |
| Mercy Hospital ScrantonScranton | 21 | $41,664 | $3,404 | $2,713 |
| Lewistown HospitalLewistown | 20 | $25,532 | $1,819 | $1,449 |
| Robert Packer HospitalSayre | 20 | $22,774 | $3,501 | $2,790 |
| Jefferson Health- NortheastPhiladelphia | 20 | $18,845 | $3,701 | $2,948 |
| Pocono Medical CenterEast Stroudsburg | 20 | $27,226 | $3,570 | $2,814 |
| Penn State Health Hampden Medical CenterEnola | 20 | $37,120 | $3,416 | $2,721 |
| Chestnut Hill HospitalPhiladelphia | 18 | $58,635 | $3,703 | $2,951 |
| Penn Presbyterian Medical CenterPhiladelphia | 18 | $57,070 | $3,840 | $3,060 |
| St Mary Medical CenterLanghorne | 18 | $27,668 | $3,788 | $3,018 |
| UPMC LititzLititz | 17 | $20,956 | $3,426 | $2,730 |
| Wilkes-Barre General HospitalWilkes-Barre | 17 | $46,897 | $3,404 | $2,713 |
| Western Pennsylvania Hosp Forbes Regional CampusMonroeville | 17 | $24,012 | $3,404 | $2,713 |
| St Luke's Hospital - Monroe CampusStroudsburg | 17 | $46,628 | $3,611 | $2,877 |
| Conemaugh Valley Memorial HospitalJohnstown | 16 | $19,440 | $3,646 | $2,905 |
| Excela Health Westmoreland Regional HospitalGreensburg | 16 | $15,601 | $3,404 | $2,713 |
| St Clair Memorial HospitalPittsburgh | 16 | $15,703 | $3,235 | $2,543 |
| Indiana Regional Medical CenterIndiana | 15 | $24,033 | $3,652 | $2,910 |
| Evangelical Community HospitalLewisburg | 13 | $38,982 | $3,404 | $2,713 |
| Chambersburg HospitalChambersburg | 13 | $23,240 | $3,803 | $3,030 |
| Mount Nittany Medical CenterState College | 13 | $29,509 | $3,846 | $3,065 |
| Jameson Memorial HospitalNew Castle | 12 | $10,144 | $3,404 | $2,713 |
| Allegheny General HospitalPittsburgh | 12 | $28,644 | $3,404 | $2,713 |
| Bloomsburg HospitalBloomsburg | 11 | $44,514 | $3,404 | $2,713 |
| Monongahela Valley HospitalMonongahela | 11 | $17,215 | $3,404 | $2,713 |
| Doylestown HospitalDoylestown | 11 | $27,011 | $3,677 | $2,930 |
| Holy Spirit HospitalCamp Hill | – | – | – | – |
| Lansdale HospitalLansdale | – | – | – | – |
| Temple University HospitalPhiladelphia | – | – | – | – |
| UPMC MercyPittsburgh | – | – | – | – |
| Schuylkill Medical Center - South Jackson StreetPottsville | – | – | – | – |
| Allegheny Valley HospitalNatrona Heights | – | – | – | – |
| St Luke's Quakertown HospitalQuakertown | – | – | – | – |
| Heritage Valley BeaverBeaver | – | – | – | – |
| Heritage Valley SewickleySewickley | – | – | – | – |
| Uniontown HospitalUniontown | – | – | – | – |
| Washington Hospital, theWashington | – | – | – | – |
| Penn Highlands HuntingdonHuntingdon | – | – | – | – |
| Carlisle Regional Medical CtrCarlisle | – | – | – | – |
| Nason HospitalRoaring Spring | – | – | – | – |
| Altoona Regional Health SystemAltoona | – | – | – | – |
| Northwest Medical CenterOil City | – | – | – | – |
| Clarion HospitalClarion | – | – | – | – |
| UPMC St MargaretPittsburgh | – | – | – | – |
| Windber HospitalWindber | – | – | – | – |
| Meadville Medical CenterMeadville | – | – | – | – |
| Mercy Suburban HospitalNorristown | – | – | – | – |
| Pottstown Memorial Med CenterPottstown | – | – | – | – |
| Warren General HospitalWarren | – | – | – | – |
| Mercy Health SystemConshohocken | – | – | – | – |
| Easton HospitalEaston | – | – | – | – |
| Butler Health SystemButler | – | – | – | – |
| UPMC HorizonGreenville | – | – | – | – |
| Hazleton General HospitalHazleton | – | – | – | – |
| Punxsutawney Area HospitalPunxsutawney | – | – | – | – |
| Nazareth HospitalPhiladelphia | – | – | – | – |
| Sharon Regional Health SystemSharon | – | – | – | – |
| Latrobe Area HospitalLatrobe | – | – | – | – |
| Abington Memorial HospitalAbington | – | – | – | – |
| Hanover HospitalHanover | – | – | – | – |
| Grove City Medical CenterGrove City | – | – | – | – |
| Roxborough Memorial HospitalPhiladelphia | – | – | – | – |
| Surgical Institute of ReadingWyomissing | – | – | – | – |
| Physicians Care Surgical HospitalRoyersford | – | – | – | – |
| UPMC EastMonroeville | – | – | – | – |
| Geisinger St. Luke's HospitalOrwigsburg | – | – | – | – |
| St Luke's Hospital - Carbon CampusLehighton | – | – | – | – |
| Penn State Health Lancaster Medical CenterLancaster | – | – | – | – |
Lowest and highest allowed amounts in Pennsylvania
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
| Lewistown HospitalLewistown, PA | $1,819 |
|---|---|
| UPMC MemorialYork, PA | $1,838 |
| Gettysburg HospitalGettysburg, PA | $2,678 |
| Magee Womens Hospital of UPMC Health SystemPittsburgh, PA | $2,923 |
| Geisinger Wyoming Vly Med CtrWilkes-Barre, PA | $3,048 |
Highest
| Saint Vincent Health CenterErie, PA | $4,017 |
|---|---|
| Hamot Medical CenterErie, PA | $4,017 |
| Mount Nittany Medical CenterState College, PA | $3,846 |
| Penn Presbyterian Medical CenterPhiladelphia, PA | $3,840 |
| Pennsylvania Hosp of the Univ of Pa Health SysPhiladelphia, PA | $3,840 |
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 Pennsylvania?
In 2024 Medicare data, level 1 breast/lymphatic surgery and related procedures (APC 5091) at 109 hospitals in Pennsylvania was billed at $32,703 on average, while the average medicare-allowed amount was $3,508, of which Medicare paid $2,791. 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 Pennsylvania, average charges were 9.3 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.