Level 3 Breast/Lymphatic Surgery and Related Procedures
What 986 hospitals in the U.S. charged and were paid for level 3 breast/lymphatic surgery and related procedures (APC 5093), from 2024 Medicare claims.
Average charge
$76,154
Hospital list price billed
Average allowed
$9,171
Medicare's payment + patient's share
Medicare paid
$7,546
Average per service
Volume
2,037
Medicare services
Hospitals in the U.S. billed an average of $76,154 for level 3 breast/lymphatic surgery and related procedures, about 8.3 times the average medicare-allowed amount of $9,171.
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 $9,171Billed $76,154
About 12¢ was paid for every $1 hospitals in the U.S. billed for this service.
Lowest and highest allowed amounts
Among hospitals with at least 20 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Hospital of the Univ of PaPhiladelphia, PA | $7,302 |
|---|---|
| Vanderbilt University HospitalNashville, TN | $7,702 |
| William Beaumont Hospital-TroyTroy, MI | $7,957 |
| Barnes-Jewish West County HospitalSt Louis, MO | $8,086 |
| Mercy Health Center, INCOklahoma City, OK | $8,121 |
| Adventhealth OrlandoOrlando, FL | $8,230 |
| University of Kansas HospitalKansas City, KS | $8,262 |
| Northside HospitalAtlanta, GA | $8,371 |
| North Central Surgical Center LLPDallas, TX | $8,481 |
| Sarasota Memorial HospitalSarasota, FL | $8,537 |
Highest
| City of Hope Natl Medical CtrDuarte, CA | $11,575 |
|---|---|
| Cedars-Sinai Medical CenterLos Angeles, CA | $11,575 |
| UCLA Medical CenterLos Angeles, CA | $11,575 |
| Scripps Memorial Hospital la JollaLa Jolla, CA | $11,575 |
| Mem Sloan-Kettering Cancer CtrNew York, NY | $10,716 |
| Glen Cove HospitalGlen Cove, NY | $10,611 |
| NYU Hospitals CenterNew York, NY | $10,604 |
| Massachusetts General HospitalBoston, MA | $10,115 |
| Christiana Care Health Services, INC.Newark, DE | $9,452 |
| Scottsdale Healthcare-Shea Medical CenterScottsdale, AZ | $9,187 |
Level 3 Breast/Lymphatic Surgery and Related Procedures cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg allowed | Range |
|---|---|---|---|---|
| Alabama | 15 | $190,526 | $6,824 | $6,824 – $6,824 |
| Alaska | 1 | – | – | – |
| Arizona | 20 | $120,678 | $9,187 | $9,187 – $9,187 |
| Arkansas | 10 | – | – | – – – |
| California | 86 | $99,428 | $11,898 | $11,575 – $13,253 |
| Colorado | 22 | $91,121 | $8,817 | $8,511 – $8,970 |
| Connecticut | 14 | – | – | – – – |
| Delaware | 4 | $18,912 | $9,452 | $9,452 – $9,452 |
| Florida | 69 | $84,978 | $8,497 | $8,230 – $8,537 |
| Georgia | 33 | $69,001 | $8,191 | $7,131 – $8,593 |
| Hawaii | 5 | – | – | – – – |
| Idaho | 4 | – | – | – – – |
| Illinois | 46 | $57,552 | $8,972 | $8,787 – $9,164 |
| Indiana | 20 | – | – | – – – |
| Iowa | 8 | – | – | – – – |
| Kansas | 9 | $78,159 | $8,262 | $8,262 – $8,262 |
| Kentucky | 14 | $152,603 | $8,121 | $8,121 – $8,121 |
| Louisiana | 17 | $67,818 | $7,993 | $7,830 – $8,169 |
| Maine | 5 | – | – | – – – |
| Massachusetts | 28 | $41,594 | $9,976 | $9,420 – $10,115 |
| Michigan | 31 | $57,425 | $8,127 | $7,957 – $8,400 |
| Minnesota | 17 | $47,762 | $9,255 | $9,255 – $9,255 |
| Mississippi | 4 | $71,852 | $5,906 | $5,906 – $5,906 |
| Missouri | 21 | $50,961 | $7,992 | $7,926 – $8,086 |
| Montana | 6 | – | – | – – – |
| Nebraska | 11 | $40,908 | $7,869 | $7,869 – $7,869 |
| Nevada | 7 | – | – | – – – |
| New Hampshire | 7 | $37,455 | $9,624 | $9,624 – $9,624 |
| New Jersey | 33 | $59,017 | $10,271 | $9,861 – $10,598 |
| New Mexico | 6 | $80,861 | $9,540 | $9,540 – $9,540 |
| New York | 51 | $61,116 | $10,613 | $10,238 – $10,716 |
| North Carolina | 28 | $100,720 | $8,433 | $7,857 – $8,783 |
| North Dakota | 3 | – | – | – – – |
| Ohio | 39 | $41,428 | $8,079 | $7,620 – $8,428 |
| Oklahoma | 6 | $40,767 | $8,121 | $8,121 – $8,121 |
| Oregon | 11 | – | – | – – – |
| Pennsylvania | 49 | $65,144 | $7,302 | $7,302 – $7,302 |
| Rhode Island | 4 | – | – | – – – |
| South Carolina | 24 | $56,206 | $8,116 | $8,101 – $8,131 |
| South Dakota | 5 | $75,170 | $8,749 | $8,664 – $8,835 |
| Tennessee | 22 | $47,365 | $7,651 | $7,254 – $8,121 |
| Texas | 72 | $69,099 | $8,427 | $7,911 – $8,738 |
| Utah | 14 | – | – | – – – |
| Vermont | 2 | – | – | – – – |
| Virginia | 30 | $88,864 | $8,406 | $8,068 – $8,836 |
| Washington | 21 | $59,270 | $9,493 | $8,934 – $10,093 |
| West Virginia | 5 | – | – | – – – |
| Wisconsin | 21 | – | – | – – – |
| Wyoming | 2 | – | – | – – – |
Hospitals that treat the most Medicare patients for this
| Hospital | Services | Avg charge | Avg allowed |
|---|---|---|---|
| H Lee Moffitt Cancer CenterTampa, FL | 66 | $49,214 | $8,537 |
| Mem Sloan-Kettering Cancer CtrNew York, NY | 59 | $28,555 | $10,716 |
| Sarasota Memorial HospitalSarasota, FL | 46 | $135,769 | $8,537 |
| Adventhealth OrlandoOrlando, FL | 45 | $102,054 | $8,230 |
| Scottsdale Healthcare-Shea Medical CenterScottsdale, AZ | 43 | $157,251 | $9,187 |
| Northside HospitalAtlanta, GA | 42 | $55,873 | $8,371 |
| Univ of Tx M D Anderson CtrHouston, TX | 40 | $31,161 | $8,738 |
| NYU Hospitals CenterNew York, NY | 35 | $126,483 | $10,604 |
| Mercy Health Center, INCOklahoma City, OK | 35 | $40,767 | $8,121 |
| Vanderbilt University HospitalNashville, TN | 31 | $59,637 | $7,702 |
| Mayo Clinic HospitalPhoenix, AZ | 30 | $39,643 | $9,187 |
| Massachusetts General HospitalBoston, MA | 30 | $56,808 | $10,115 |
| City of Hope Natl Medical CtrDuarte, CA | 29 | $133,913 | $11,575 |
| Scripps Memorial Hospital la JollaLa Jolla, CA | 29 | $134,017 | $11,575 |
| William Beaumont Hospital-TroyTroy, MI | 29 | $47,985 | $7,957 |
Questions
How much does level 3 breast/lymphatic surgery and related procedures cost in the U.S.?
In 2024 Medicare data, level 3 breast/lymphatic surgery and related procedures (APC 5093) at 986 hospitals in the U.S. was billed at $76,154 on average, while the average medicare-allowed amount was $9,171, of which Medicare paid $7,546. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for level 3 breast/lymphatic surgery and related procedures?
Among states with at least three hospitals reporting, the average medicare-allowed amount was highest in California ($11,898), New York ($10,613), New Jersey ($10,271) and lowest in Mississippi ($5,906), Alabama ($6,824), Pennsylvania ($7,302).
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 the U.S., 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.