Level 1 Breast/Lymphatic Surgery and Related Procedures in Virginia
What 60 hospitals in Virginia charged and were paid for level 1 breast/lymphatic surgery and related procedures (APC 5091), from 2024 Medicare claims.
Average charge
$28,803
Hospital list price billed
Average allowed
$3,395
Medicare's payment + patient's share
Medicare paid
$2,695
Average per service
State rank
#19 of 49
1 = lowest average payment
Hospitals in Virginia billed an average of $28,803 for level 1 breast/lymphatic surgery and related procedures, about 8.5 times the average medicare-allowed amount of $3,395. That payment is 8% 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 $3,395Billed $28,803
About 12¢ was paid for every $1 hospitals in Virginia billed for this service.
Virginia hospitals: level 1 breast/lymphatic surgery and related procedures
Every Virginia hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Inova Fairfax HospitalFalls Church | 165 | $21,023 | $3,505 | $2,778 |
| University of Virginia Medical CenterCharlottesville | 136 | $23,032 | $3,481 | $2,770 |
| Cjw Medical CenterRichmond | 107 | $78,182 | $3,233 | $2,565 |
| Winchester Medical Center INCWinchester | 105 | $15,738 | $3,692 | $2,930 |
| Sentara Leigh HospitalNorfolk | 91 | $19,183 | $3,259 | $2,584 |
| Medical College of Virginia HospitalsRichmond | 74 | $44,176 | $3,218 | $2,544 |
| Centra Health - Lynchburg Gen HospitalLynchburg | 73 | $24,367 | $3,514 | $2,800 |
| Inova Fair Oaks HospitalFairfax | 73 | $14,963 | $3,535 | $2,809 |
| Bon Secours - St Marys Hospital of RichmondRichmond | 60 | $21,544 | $3,500 | $2,784 |
| Carilion Medical CenterRoanoke | 58 | $33,325 | $3,206 | $2,539 |
| Martha Jefferson HospitalCharlottesville | 56 | $14,886 | $3,173 | $2,498 |
| Henrico Doctors' HospitalRichmond | 49 | $73,779 | $3,252 | $2,573 |
| Sentara Careplex HospitalHampton | 46 | $24,703 | $3,317 | $2,642 |
| Inova Loudoun HospitalLeesburg | 42 | $16,489 | $3,507 | $2,780 |
| Riverside Regional Medical CenterNewport News | 41 | $15,263 | $3,234 | $2,565 |
| Augusta HealthFishersville | 40 | $21,998 | $3,611 | $2,862 |
| Bon Secours - St Francis Medical CenterMidlothian | 38 | $17,428 | $3,316 | $2,642 |
| Inova Alexandria HospitalAlexandria | 37 | $20,369 | $3,497 | $2,771 |
| Sentara Norfolk General HospitalNorfolk | 35 | $33,493 | $3,317 | $2,642 |
| Sentara Bayside HospitalVirginia Beach | 35 | $21,470 | $3,317 | $2,642 |
| Bon Secours - Memorial Regional MedicalMechanicsville | 33 | $22,166 | $3,415 | $2,704 |
| Sentara Williamsburg Regional Medical CenterWilliamsburg | 32 | $23,872 | $3,282 | $2,614 |
| Sentara Rmh Medical CenterHarrisonburg | 26 | $16,274 | $3,748 | $2,987 |
| Virginia Hospital Center - ArlingtonArlington | 26 | $21,152 | $3,574 | $2,848 |
| Chesapeake General HospitalChesapeake | 22 | $23,552 | $3,317 | $2,642 |
| Bon Secours - Maryview Medical CenterPortsmouth | 21 | $23,205 | $3,157 | $2,490 |
| Lewisgale Medical CenterSalem | 21 | $62,062 | $3,032 | $2,365 |
| Danville Regional Medical CenterDanville | 21 | $37,375 | $3,387 | $2,699 |
| Montgomery Regional HospitalBlacksburg | 20 | $54,100 | $3,155 | $2,485 |
| Southside Regional Medical CenterPetersburg | 16 | $49,276 | $3,317 | $2,642 |
| UVA Health Haymarket Medical CenterHaymarket | 16 | $23,924 | $3,604 | $2,872 |
| Riverside Shore Memorial HospitalNassawadox | 13 | $16,485 | $3,514 | $2,798 |
| Sentara Obici HospitalSuffolk | 12 | $22,856 | $3,145 | $2,506 |
| John Randolph Medical CenterHopewell | 11 | $62,073 | $3,317 | $2,641 |
| Inova Mount Vernon HospitalAlexandria | 11 | $18,174 | $3,315 | $2,589 |
| Riverside Walter Reed HospitalGloucester | 11 | $13,428 | $3,282 | $2,615 |
| Halifax Regional HospitalSouth Boston | – | – | – | – |
| Culpeper Regional HospitalCulpeper | – | – | – | – |
| Mary Washington Hospital, INCFredericksburg | – | – | – | – |
| The Fauquier Hospital, INCWarrenton | – | – | – | – |
| Warren Memorial HospitalFront Royal | – | – | – | – |
| Mary Immaculate HospitalNewport News | – | – | – | – |
| Carilion New River Vly Med CtrChristiansburg | – | – | – | – |
| Prince William HospitalManassas | – | – | – | – |
| Johnston Memorial HospitalAbingdon | – | – | – | – |
| Sentara Virginia Beach General HospitalVirginia Beach | – | – | – | – |
| Clinch Valley Medical CenterRichlands | – | – | – | – |
| Riverside Tappahannock HospitalTappahannock | – | – | – | – |
| Carilion Franklin Memorial HospitalRocky Mount | – | – | – | – |
| Southside Community Hospital, INCFarmville | – | – | – | – |
| Community Memorial Healthcenter, INCSouth Hill | – | – | – | – |
| Reston Hospital CenterReston | – | – | – | – |
| Sentara Northern Virginia Medical CenterWoodbridge | – | – | – | – |
| Wellmont Lonesome Pine HospitalBig Stone Gap | – | – | – | – |
| Twin County Regional HospitalGalax | – | – | – | – |
| Alleghany Regional HospitalJackson River | – | – | – | – |
| Stafford Hospital CenterStafford | – | – | – | – |
| Spotsylvania Regional Medical CenterFredericksburg | – | – | – | – |
| Riverside Doctors' Hospital of WilliamsburgWilliamsburg | – | – | – | – |
| Stonesprings Hospital CenterDulles | – | – | – | – |
Lowest and highest allowed amounts in Virginia
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
| Lewisgale Medical CenterSalem, VA | $3,032 |
|---|---|
| Sentara Obici HospitalSuffolk, VA | $3,145 |
| Montgomery Regional HospitalBlacksburg, VA | $3,155 |
| Bon Secours - Maryview Medical CenterPortsmouth, VA | $3,157 |
| Martha Jefferson HospitalCharlottesville, VA | $3,173 |
Highest
| Sentara Rmh Medical CenterHarrisonburg, VA | $3,748 |
|---|---|
| Winchester Medical Center INCWinchester, VA | $3,692 |
| Augusta HealthFishersville, VA | $3,611 |
| UVA Health Haymarket Medical CenterHaymarket, VA | $3,604 |
| Virginia Hospital Center - ArlingtonArlington, VA | $3,574 |
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 Virginia?
In 2024 Medicare data, level 1 breast/lymphatic surgery and related procedures (APC 5091) at 60 hospitals in Virginia was billed at $28,803 on average, while the average medicare-allowed amount was $3,395, of which Medicare paid $2,695. 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 Virginia, average charges were 8.5 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.