facebook tracking Level 3 Breast/Lymphatic Surgery and Related Procedures cost in Massachusetts: 28 hospitals compared (APC 5093)

Level 3 Breast/Lymphatic Surgery and Related Procedures in Massachusetts

What 28 hospitals in Massachusetts 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 $41,594 Hospital list price billed
Average allowed $9,976 Medicare's payment + patient's share
Medicare paid $8,342 Average per service
State rank #28 of 31 1 = lowest average payment

Hospitals in Massachusetts billed an average of $41,594 for level 3 breast/lymphatic surgery and related procedures, about 4.2 times the average medicare-allowed amount of $9,976. That payment is 9% above 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 $9,976Billed $41,594

About 24¢ was paid for every $1 hospitals in Massachusetts billed for this service.

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

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

Hospital Services Avg charge Avg allowed Medicare paid
Massachusetts General HospitalBoston 30 $56,808 $10,115 $8,483
Faulkner HospitalBoston 18 $31,569 $10,115 $8,483
Beth Israel Deaconess Medical CenterBoston 12 $18,596 $9,420 $7,776
Mount Auburn HospitalCambridge – – – –
Sturdy Memorial HospitalAttleboro – – – –
Lawrence General HospitalLawrence – – – –
Cape Cod HospitalHyannis – – – –
Cooley Dickinson Hospital Inc,TheNorthampton – – – –
Harrington Memorial HospitalSouthbridge – – – –
Anna Jaques HospitalNewburyport – – – –
Beverly Hospital CorporationBeverly – – – –
Union HospitalLynn – – – –
Berkshire Medical Center INCPittsfield – – – –
Beth Israel Deaconess Hospital PlymouthPlymouth – – – –
Lowell General HospitalLowell – – – –
Melrosewakefield HealthcareMelrose – – – –
Southcoast Hospital Group, INCFall River – – – –
Baystate Medical CenterSpringfield – – – –
Beth Israel Deaconess Hospital - NeedhamNeedham – – – –
Emerson HospitalConcord – – – –
South Shore HospitalSouth Weymouth – – – –
Newton-Wellesley HospitalNewton Lower Falls – – – –
Winchester HospitalWinchester – – – –
Brigham and Women's HosptialBoston – – – –
Tufts Medical CenterBoston – – – –
Umass Memorial Medical Center INCWorcester – – – –
Lahey Clinic HospitalBurlington – – – –
Metrowest Medical CenterFramingham – – – –
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Lowest and highest allowed amounts in Massachusetts

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

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 Massachusetts?

In 2024 Medicare data, level 3 breast/lymphatic surgery and related procedures (APC 5093) at 28 hospitals in Massachusetts was billed at $41,594 on average, while the average medicare-allowed amount was $9,976, of which Medicare paid $8,342. 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 Massachusetts, average charges were 4.2 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.