facebook tracking Level 2 Breast/Lymphatic Surgery and Related Procedures cost in South Dakota: 14 hospitals compared (APC 5092)

Level 2 Breast/Lymphatic Surgery and Related Procedures in South Dakota

What 14 hospitals in South Dakota charged and were paid for level 2 breast/lymphatic surgery and related procedures (APC 5092), from 2024 Medicare claims.

APC 5092 Outpatient 2024 Medicare data
Average charge $34,787 Hospital list price billed
Average allowed $6,105 Medicare's payment + patient's share
Medicare paid $4,859 Average per service
State rank #29 of 49 1 = lowest average payment

Hospitals in South Dakota billed an average of $34,787 for level 2 breast/lymphatic surgery and related procedures, about 5.7 times the average medicare-allowed amount of $6,105. That payment is 3% below the U.S. average of $6,262.

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 $6,105Billed $34,787

About 18¢ was paid for every $1 hospitals in South Dakota billed for this service.

South Dakota hospitals: level 2 breast/lymphatic surgery and related procedures

Every South Dakota hospital that billed Medicare for this service at least 11 times. Click a column to sort.

Hospital Services Avg charge Avg allowed Medicare paid
Avera McKennan Hospital & University Health CenterSioux Falls 137 $42,788 $6,051 $4,807
Sanford Usd Medical CenterSioux Falls 117 $30,198 $5,995 $4,777
Same Day Surgery Center LLCRapid City 47 $30,970 $6,114 $4,871
Rapid City Regional HospitalRapid City 19 $38,179 $6,548 $5,217
Avera St LukesAberdeen 14 $27,858 $6,114 $4,871
Spearfish Regional HospitalSpearfish 13 $35,522 $6,548 $5,217
Avera Sacred Heart HospitalYankton 12 $27,558 $6,548 $5,217
Black Hills Surgical Hospital LLPRapid City 12 $14,212 $6,114 $4,871
Sioux Falls Surgical Hospital LLPSioux Falls 11 $32,683 $6,114 $4,871
Prairie Lakes Hosp & Care CtrWatertown – – – –
Brookings HospitalBrookings – – – –
St Mary's Healthcare CenterPierre – – – –
Dunes Surgical HospitalNorth Sioux City – – – –
Sanford Medical Center AberdeenAberdeen – – – –
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Lowest and highest allowed amounts in South Dakota

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

Highest

Avera Sacred Heart HospitalYankton, SD$6,548
Spearfish Regional HospitalSpearfish, SD$6,548
Rapid City Regional HospitalRapid City, SD$6,548
Avera St LukesAberdeen, SD$6,114
Sioux Falls Surgical Hospital LLPSioux Falls, SD$6,114

Level 2 Breast/Lymphatic Surgery and Related Procedures in other states

Questions

How much does level 2 breast/lymphatic surgery and related procedures cost in South Dakota?

In 2024 Medicare data, level 2 breast/lymphatic surgery and related procedures (APC 5092) at 14 hospitals in South Dakota was billed at $34,787 on average, while the average medicare-allowed amount was $6,105, of which Medicare paid $4,859. 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 South Dakota, average charges were 5.7 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.