Level 1 Breast/Lymphatic Surgery and Related Procedures in Wisconsin
What 54 hospitals in Wisconsin charged and were paid for level 1 breast/lymphatic surgery and related procedures (APC 5091), from 2024 Medicare claims.
Average charge
$22,684
Hospital list price billed
Average allowed
$3,529
Medicare's payment + patient's share
Medicare paid
$2,809
Average per service
State rank
#27 of 49
1 = lowest average payment
Hospitals in Wisconsin billed an average of $22,684 for level 1 breast/lymphatic surgery and related procedures, about 6.4 times the average medicare-allowed amount of $3,529. That payment is 4% 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 $3,529Billed $22,684
About 16¢ was paid for every $1 hospitals in Wisconsin billed for this service.
Wisconsin hospitals: level 1 breast/lymphatic surgery and related procedures
Every Wisconsin hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| University of Wi Hospitals & Clinics AuthorityMadison | 106 | $26,052 | $3,532 | $2,807 |
| Gundersen Luth Med CtrLa Crosse | 67 | $18,850 | $3,559 | $2,836 |
| Froedtert Mem Lutheran HsptlMilwaukee | 51 | $33,457 | $3,587 | $2,858 |
| Luther Hospital Mayo Health SystemEau Claire | 50 | $13,379 | $3,616 | $2,881 |
| Mayo Clinic Health System-Franciscan Medical CenterLa Crosse | 46 | $12,388 | $3,591 | $2,860 |
| Waukesha Memorial HospitalWaukesha | 32 | $28,090 | $3,472 | $2,767 |
| Columbia St Marys Hsptl Milw (Col & Milw Campus)Milwaukee | 32 | $27,700 | $3,587 | $2,858 |
| Aurora St Lukes Medical CenterMilwaukee | 26 | $32,083 | $3,581 | $2,852 |
| Bellin Memorial HsptlGreen Bay | 21 | $22,952 | $3,281 | $2,588 |
| Aurora Med Ctr KenoshaKenosha | 21 | $29,939 | $3,585 | $2,856 |
| Appleton Med CtrAppleton | 20 | $13,819 | $3,435 | $2,734 |
| Community Mem HsptlMenomonee Falls | 19 | $24,289 | $3,472 | $2,767 |
| Aurora Medical CenterGrafton | 18 | $27,968 | $3,319 | $2,613 |
| St Mary's HospitalMadison | 17 | $17,351 | $3,558 | $2,824 |
| Marshfield Medical CenterMarshfield | 16 | $15,104 | $3,653 | $2,910 |
| Aurora Memorial Hsptl BurlingtonBurlington | 16 | $21,778 | $3,585 | $2,856 |
| St Marys Hsptl Med CtrGreen Bay | 15 | $26,174 | $3,428 | $2,731 |
| Aurora Sheboygan Mem Med CtrSheboygan | 14 | $19,935 | $3,472 | $2,767 |
| Mercy Hlth Sys CorpJanesville | 14 | $23,381 | $3,472 | $2,767 |
| Aurora Baycare Med CtrGreen Bay | 13 | $20,005 | $3,432 | $2,734 |
| Aurora Medical CenterSummit | 13 | $18,329 | $3,475 | $2,769 |
| Marshfield Medical Center - Eau ClaireEau Claire | 13 | $14,084 | $3,426 | $2,725 |
| Froedtert SouthKenosha | 12 | $19,164 | $3,585 | $2,856 |
| Wheaton Franciscan Healthcare- All SaintsRacine | 12 | $22,293 | $3,587 | $2,858 |
| Aurora West Allis Medical CenterWest Allis | 12 | $26,952 | $3,461 | $2,755 |
| St Josephs Com Hsptl West BendWest Bend | 11 | $23,300 | $3,472 | $2,767 |
| Ministry St Michaels Hospital of Stevens PointStevens Point | – | – | – | – |
| St Elizabeth HsptlAppleton | – | – | – | – |
| Marshfield Medical Center - Rice LakeRice Lake | – | – | – | – |
| Aspirus Rhinelander HospitalRhinelander | – | – | – | – |
| Monroe ClinicMonroe | – | – | – | – |
| Aspirus Wausau HospitalWausau | – | – | – | – |
| Aurora Med Ctr Manitowoc CtyTwo Rivers | – | – | – | – |
| Divine Savior HlthcarePortage | – | – | – | – |
| St Nicholas HospitalSheboygan | – | – | – | – |
| Thedacare Regional Med Ctr - NeenahNeenah | – | – | – | – |
| St Clare Hsptl Hlth SvcsBaraboo | – | – | – | – |
| Oconomowoc Mem HsptlOconomowoc | – | – | – | – |
| Fort HealthcareFort Atkinson | – | – | – | – |
| Beaver Dam Com HsptlBeaver Dam | – | – | – | – |
| St Agnes HsptlFond du Lac | – | – | – | – |
| Meriter HsptlMadison | – | – | – | – |
| Sauk Prairie Mem HsptlPrairie du Sac | – | – | – | – |
| Beloit Mem HsptlBeloit | – | – | – | – |
| Holy Family Memorial INCManitowoc | – | – | – | – |
| Mile Bluff Medical Center, INCMauston | – | – | – | – |
| Bay Area Med CtrMarinette | – | – | – | – |
| UW Hlth Partners - Watertown Regional Medical CtrWatertown | – | – | – | – |
| Ascension SE Wisconsin HospitalMilwaukee | – | – | – | – |
| Oakleaf Surgical HospitalEau Claire | – | – | – | – |
| Aurora Med Ctr OshkoshOshkosh | – | – | – | – |
| St Clare's Hospital of Weston INCWeston | – | – | – | – |
| SSM Health St Mary's Hospital - JanesvilleJanesville | – | – | – | – |
| Marshfield Medical Center - MinocquaMinocqua | – | – | – | – |
Lowest and highest allowed amounts in Wisconsin
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
| Bellin Memorial HsptlGreen Bay, WI | $3,281 |
|---|---|
| Aurora Medical CenterGrafton, WI | $3,319 |
| Marshfield Medical Center - Eau ClaireEau Claire, WI | $3,426 |
| St Marys Hsptl Med CtrGreen Bay, WI | $3,428 |
| Aurora Baycare Med CtrGreen Bay, WI | $3,432 |
Highest
| Marshfield Medical CenterMarshfield, WI | $3,653 |
|---|---|
| Luther Hospital Mayo Health SystemEau Claire, WI | $3,616 |
| Mayo Clinic Health System-Franciscan Medical CenterLa Crosse, WI | $3,591 |
| Columbia St Marys Hsptl Milw (Col & Milw Campus)Milwaukee, WI | $3,587 |
| Wheaton Franciscan Healthcare- All SaintsRacine, WI | $3,587 |
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 Wisconsin?
In 2024 Medicare data, level 1 breast/lymphatic surgery and related procedures (APC 5091) at 54 hospitals in Wisconsin was billed at $22,684 on average, while the average medicare-allowed amount was $3,529, of which Medicare paid $2,809. 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 Wisconsin, average charges were 6.4 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.