Level 1 Breast/Lymphatic Surgery and Related Procedures in West Virginia
What 20 hospitals in West Virginia charged and were paid for level 1 breast/lymphatic surgery and related procedures (APC 5091), from 2024 Medicare claims.
Average charge
$21,388
Hospital list price billed
Average allowed
$3,207
Medicare's payment + patient's share
Medicare paid
$2,544
Average per service
State rank
#6 of 49
1 = lowest average payment
Hospitals in West Virginia billed an average of $21,388 for level 1 breast/lymphatic surgery and related procedures, about 6.7 times the average medicare-allowed amount of $3,207. That payment is 13% 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 $3,207Billed $21,388
About 15¢ was paid for every $1 hospitals in West Virginia billed for this service.
West Virginia hospitals: level 1 breast/lymphatic surgery and related procedures
Every West 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 |
|---|---|---|---|---|
| West Virginia University HospitalsMorgantown | 78 | $23,417 | $3,189 | $2,541 |
| Charleston Area Medical CenterCharleston | 42 | $24,557 | $3,047 | $2,387 |
| Wheeling HospitalWheeling | 39 | $18,719 | $3,124 | $2,476 |
| United Hospital CenterBridgeport | 29 | $14,697 | $3,632 | $2,894 |
| Cabell-Huntington Hospital INCHuntington | 28 | $17,441 | $3,160 | $2,500 |
| Mon Health Medical CenterMorgantown | 22 | $33,420 | $3,228 | $2,572 |
| Princeton Community HospitalPrinceton | 21 | $21,417 | $3,409 | $2,716 |
| Weirton Medical CenterWeirton | 17 | $25,594 | $3,189 | $2,541 |
| Thomas Memorial HospitalSouth Charleston | 17 | $21,544 | $3,080 | $2,423 |
| Camden Clark Memorial HospitalParkersburg | 15 | $12,127 | $3,231 | $2,574 |
| St Mary's Medical CenterHuntington | 12 | $14,445 | $3,031 | $2,371 |
| Greenbrier Valley Medical CenterRonceverte | – | – | – | – |
| Berkeley Medical CenterMartinsburg | – | – | – | – |
| Reynolds Memorial HospitalGlen Dale | – | – | – | – |
| Davis Memorial HospitalElkins | – | – | – | – |
| Stonewall Jackson Mem HospWeston | – | – | – | – |
| Logan Regional Medical CenterLogan | – | – | – | – |
| Beckley Arh HospitalBeckley | – | – | – | – |
| Raleigh General HospitalBeckley | – | – | – | – |
| Camc Charleston Surgical HospitalCharleston | – | – | – | – |
Lowest and highest allowed amounts in West 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
| St Mary's Medical CenterHuntington, WV | $3,031 |
|---|---|
| Charleston Area Medical CenterCharleston, WV | $3,047 |
| Thomas Memorial HospitalSouth Charleston, WV | $3,080 |
| Wheeling HospitalWheeling, WV | $3,124 |
| Cabell-Huntington Hospital INCHuntington, WV | $3,160 |
Highest
| United Hospital CenterBridgeport, WV | $3,632 |
|---|---|
| Princeton Community HospitalPrinceton, WV | $3,409 |
| Camden Clark Memorial HospitalParkersburg, WV | $3,231 |
| Mon Health Medical CenterMorgantown, WV | $3,228 |
| West Virginia University HospitalsMorgantown, WV | $3,189 |
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 West Virginia?
In 2024 Medicare data, level 1 breast/lymphatic surgery and related procedures (APC 5091) at 20 hospitals in West Virginia was billed at $21,388 on average, while the average medicare-allowed amount was $3,207, of which Medicare paid $2,544. 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 West Virginia, average charges were 6.7 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.