What 6 hospitals in Vermont charged and were paid for level 2 excision/biopsy/incision and drainage (APC 5072), from 2024 Medicare claims.
Hospitals in Vermont billed an average of $6,527 for level 2 excision/biopsy/incision and drainage, about 8.3 times the average medicare-allowed amount of $787. That payment is 49% below 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.
About 12¢ was paid for every $1 hospitals in Vermont billed for this service.
Every Vermont hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Fletcher Allen Hospital of VermontBurlington | 596 | $7,243 | $763 | $439 |
| Rutland Regional Medical CenterRutland | 199 | $6,606 | $836 | $517 |
| Southwestern Vermont Medical CenterBennington | 128 | $4,006 | $949 | $618 |
| Central Vermont Medical CenterGraniteville-East Barre | 94 | $4,710 | $622 | $300 |
| Brattleboro Memorial HospitalBrattleboro | 39 | $9,540 | $856 | $555 |
| Northwestern Medical CenterSt Albans | 24 | $3,794 | $633 | $313 |
Among hospitals with at least 11 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
| Central Vermont Medical CenterGraniteville-East Barre, VT | $622 |
|---|---|
| Northwestern Medical CenterSt Albans, VT | $633 |
| Fletcher Allen Hospital of VermontBurlington, VT | $763 |
| Rutland Regional Medical CenterRutland, VT | $836 |
| Brattleboro Memorial HospitalBrattleboro, VT | $856 |
| Southwestern Vermont Medical CenterBennington, VT | $949 |
|---|---|
| Brattleboro Memorial HospitalBrattleboro, VT | $856 |
| Rutland Regional Medical CenterRutland, VT | $836 |
| Fletcher Allen Hospital of VermontBurlington, VT | $763 |
| Northwestern Medical CenterSt Albans, VT | $633 |
In 2024 Medicare data, level 2 excision/biopsy/incision and drainage (APC 5072) at 6 hospitals in Vermont was billed at $6,527 on average, while the average medicare-allowed amount was $787, of which Medicare paid $464. Your own cost depends on your insurance, deductible and the hospital.
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 Vermont, average charges were 8.3 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.