facebook tracking Level 3 Breast/Lymphatic Surgery and Related Procedures cost in Colorado: 22 hospitals compared (APC 5093)

Level 3 Breast/Lymphatic Surgery and Related Procedures in Colorado

What 22 hospitals in Colorado charged and were paid for level 3 breast/lymphatic surgery and related procedures (APC 5093), from 2024 Medicare claims.

APC 5093 Outpatient 2024 Medicare data
Average charge $91,121 Hospital list price billed
Average allowed $8,817 Medicare's payment + patient's share
Medicare paid $7,178 Average per service
State rank #20 of 31 1 = lowest average payment

Hospitals in Colorado billed an average of $91,121 for level 3 breast/lymphatic surgery and related procedures, about 10.3 times the average medicare-allowed amount of $8,817. That payment is 4% below the U.S. average 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 $8,817Billed $91,121

About 10¢ was paid for every $1 hospitals in Colorado billed for this service.

Colorado hospitals: level 3 breast/lymphatic surgery and related procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
Memorial Hospital CentralColorado Springs 16 $117,728 $8,511 $6,879
University of Colorado Hospital Anschutz InpatientAurora 16 $111,600 $8,970 $7,316
Centura Health-Avista Adventist HospitalLouisville 16 $44,036 $8,970 $7,338
Exempla Lutheran Medical CenterWheat Ridge – – – –
Poudre Valley HospitalFort Collins – – – –
Mercy Medical CenterDurango – – – –
Presbyterian/St Luke's Medical CenterDenver – – – –
Parkview Medical Center INCPueblo – – – –
St Mary's Hospital and Medical CenterGrand Junction – – – –
Banner North Co Medical Center - Loveland CampusLoveland – – – –
Centura Health-Penrose St Francis Health ServicesColorado Springs – – – –
Rose Medical CenterDenver – – – –
Community HospitalGrand Junction – – – –
Valley View Hospital AssociationGlenwood Springs – – – –
Vail Valley Medical CenterVail – – – –
Centura Health-St Anthony North HospitalWestminster – – – –
Parker Adventist HospitalParker – – – –
Animas Surgical Hospital, LLCDurango – – – –
Medical Center of the RockiesLoveland – – – –
Adventhealth Castle RockCastle Rock – – – –
Longs Peak HospitalLongmont – – – –
Uchealth Highlands Ranch HospitalHighlands Ranch – – – –
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Lowest and highest allowed amounts in Colorado

Among hospitals with at least 11 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.

Level 3 Breast/Lymphatic Surgery and Related Procedures in other states

Questions

How much does level 3 breast/lymphatic surgery and related procedures cost in Colorado?

In 2024 Medicare data, level 3 breast/lymphatic surgery and related procedures (APC 5093) at 22 hospitals in Colorado was billed at $91,121 on average, while the average medicare-allowed amount was $8,817, of which Medicare paid $7,178. 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 Colorado, average charges were 10.3 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.