Level 2 Excision/Biopsy/Incision and Drainage in Rhode Island
What 10 hospitals in Rhode Island charged and were paid for level 2 excision/biopsy/incision and drainage (APC 5072), from 2024 Medicare claims.
Average charge
$7,430
Hospital list price billed
Average allowed
$1,631
Medicare's payment + patient's share
Medicare paid
$1,295
Average per service
State rank
#39 of 49
1 = lowest average payment
Hospitals in Rhode Island billed an average of $7,430 for level 2 excision/biopsy/incision and drainage, about 4.6 times the average medicare-allowed amount of $1,631. That payment is 6% above the U.S. average of $1,539.
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 $1,631Billed $7,430
About 22¢ was paid for every $1 hospitals in Rhode Island billed for this service.
Rhode Island hospitals: level 2 excision/biopsy/incision and drainage
Every Rhode Island hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Rhode Island HospitalProvidence | 349 | $7,908 | $1,632 | $1,297 |
| Kent County Memorial HospitalWarwick | 123 | $6,010 | $1,632 | $1,299 |
| South County Hospital INCWakefield | 99 | $4,906 | $1,645 | $1,307 |
| Newport HospitalNewport | 94 | $6,442 | $1,590 | $1,251 |
| Miriam HospitalProvidence | 81 | $7,716 | $1,625 | $1,293 |
| Women and Infants Hospital of Rhode IslandProvidence | 75 | $5,280 | $1,644 | $1,308 |
| Roger Williams Medical CenterProvidence | 57 | $13,516 | $1,626 | $1,286 |
| Westerly HospitalWesterly | 53 | $8,454 | $1,645 | $1,310 |
| Our Lady of Fatima HospitalNorth Providence | 29 | $7,010 | $1,645 | $1,305 |
| Landmark Medical Center, INCWoonsocket | 27 | $11,117 | $1,645 | $1,311 |
Lowest and highest allowed amounts in Rhode Island
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
| Newport HospitalNewport, RI | $1,590 |
|---|---|
| Miriam HospitalProvidence, RI | $1,625 |
| Roger Williams Medical CenterProvidence, RI | $1,626 |
| Rhode Island HospitalProvidence, RI | $1,632 |
| Kent County Memorial HospitalWarwick, RI | $1,632 |
Highest
| Our Lady of Fatima HospitalNorth Providence, RI | $1,645 |
|---|---|
| South County Hospital INCWakefield, RI | $1,645 |
| Westerly HospitalWesterly, RI | $1,645 |
| Landmark Medical Center, INCWoonsocket, RI | $1,645 |
| Women and Infants Hospital of Rhode IslandProvidence, RI | $1,644 |
Level 2 Excision/Biopsy/Incision and Drainage in other states
Questions
How much does level 2 excision/biopsy/incision and drainage cost in Rhode Island?
In 2024 Medicare data, level 2 excision/biopsy/incision and drainage (APC 5072) at 10 hospitals in Rhode Island was billed at $7,430 on average, while the average medicare-allowed amount was $1,631, of which Medicare paid $1,295. 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 Rhode Island, average charges were 4.6 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.