Level 1 Breast/Lymphatic Surgery and Related Procedures in Vermont
What 6 hospitals in Vermont charged and were paid for level 1 breast/lymphatic surgery and related procedures (APC 5091), from 2024 Medicare claims.
Average charge
$12,725
Hospital list price billed
Average allowed
$1,751
Medicare's payment + patient's share
Medicare paid
$989
Average per service
State rank
#1 of 49
1 = lowest average payment
Hospitals in Vermont billed an average of $12,725 for level 1 breast/lymphatic surgery and related procedures, about 7.3 times the average medicare-allowed amount of $1,751. That payment is 53% 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 $1,751Billed $12,725
About 14¢ was paid for every $1 hospitals in Vermont billed for this service.
Vermont hospitals: level 1 breast/lymphatic surgery and related procedures
Every Vermont hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Fletcher Allen Hospital of VermontBurlington | 76 | $11,326 | $1,819 | $1,059 |
| Central Vermont Medical CenterGraniteville-East Barre | 16 | $11,820 | $1,145 | $377 |
| Rutland Regional Medical CenterRutland | 12 | $17,320 | $1,243 | $491 |
| Southwestern Vermont Medical CenterBennington | 11 | $18,696 | $2,716 | $1,939 |
| Brattleboro Memorial HospitalBrattleboro | – | – | – | – |
| Northwestern Medical CenterSt Albans | – | – | – | – |
Lowest and highest allowed amounts in Vermont
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
| Central Vermont Medical CenterGraniteville-East Barre, VT | $1,145 |
|---|---|
| Rutland Regional Medical CenterRutland, VT | $1,243 |
| Fletcher Allen Hospital of VermontBurlington, VT | $1,819 |
| Southwestern Vermont Medical CenterBennington, VT | $2,716 |
Highest
| Southwestern Vermont Medical CenterBennington, VT | $2,716 |
|---|---|
| Fletcher Allen Hospital of VermontBurlington, VT | $1,819 |
| Rutland Regional Medical CenterRutland, VT | $1,243 |
| Central Vermont Medical CenterGraniteville-East Barre, VT | $1,145 |
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 Vermont?
In 2024 Medicare data, level 1 breast/lymphatic surgery and related procedures (APC 5091) at 6 hospitals in Vermont was billed at $12,725 on average, while the average medicare-allowed amount was $1,751, of which Medicare paid $989. 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 Vermont, average charges were 7.3 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.