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

Level 3 Breast/Lymphatic Surgery and Related Procedures in Tennessee

What 22 hospitals in Tennessee 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 $47,365 Hospital list price billed
Average allowed $7,651 Medicare's payment + patient's share
Medicare paid $6,040 Average per service
State rank #4 of 31 1 = lowest average payment

Hospitals in Tennessee billed an average of $47,365 for level 3 breast/lymphatic surgery and related procedures, about 6.2 times the average medicare-allowed amount of $7,651. That payment is 17% 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 $7,651Billed $47,365

About 16¢ was paid for every $1 hospitals in Tennessee billed for this service.

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

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

Hospital Services Avg charge Avg allowed Medicare paid
Vanderbilt University HospitalNashville 31 $59,637 $7,702 $6,100
Baptist Memorial HospitalMemphis 17 $27,323 $7,254 $5,639
St Thomas HospitalNashville 11 $43,754 $8,121 $6,489
Jackson-Madison Cnty Gen HospJackson – – – –
Blount Memorial HospitalMaryville – – – –
Wellmont Bristol Regional Medical CenterBristol – – – –
Univ of Tn Mem HospitalKnoxville – – – –
Sycamore Shoals HospitalElizabethton – – – –
Williamson Medical CenterFranklin – – – –
Methodist Med Ctr of Oak RidgeOak Ridge – – – –
Methodist Healthcare-MemphisMemphis – – – –
Maury Regional HospitalColumbia – – – –
Erlanger Medical CenterChattanooga – – – –
Physicians Regional Medical CenterKnoxville – – – –
Fort Sanders Reg Medical CtrKnoxville – – – –
Vanderbilt Bedford HospitalShelbyville – – – –
Summit Medical CenterHermitage – – – –
Centennial Medical CenterNashville – – – –
Parkwest Medical CenterKnoxville – – – –
Franklin Woods Community HospitalJohnson City – – – –
Cleveland Community HospitalCleveland – – – –
Vanderbilt Wilson County HospitalLebanon – – – –
Advertisement

Lowest and highest allowed amounts in Tennessee

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

Baptist Memorial HospitalMemphis, TN$7,254
Vanderbilt University HospitalNashville, TN$7,702
St Thomas HospitalNashville, TN$8,121

Highest

St Thomas HospitalNashville, TN$8,121
Vanderbilt University HospitalNashville, TN$7,702
Baptist Memorial HospitalMemphis, TN$7,254

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 Tennessee?

In 2024 Medicare data, level 3 breast/lymphatic surgery and related procedures (APC 5093) at 22 hospitals in Tennessee was billed at $47,365 on average, while the average medicare-allowed amount was $7,651, of which Medicare paid $6,040. 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 Tennessee, average charges were 6.2 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.