Level 3 Excision/Biopsy/Incision and Drainage in Rhode Island
What 10 hospitals in Rhode Island charged and were paid for level 3 excision/biopsy/incision and drainage (APC 5073), from 2024 Medicare claims.
Average charge
$12,681
Hospital list price billed
Average allowed
$2,698
Medicare's payment + patient's share
Medicare paid
$2,145
Average per service
State rank
#33 of 49
1 = lowest average payment
Hospitals in Rhode Island billed an average of $12,681 for level 3 excision/biopsy/incision and drainage, about 4.7 times the average medicare-allowed amount of $2,698. That payment is about the same as the U.S. average of $2,697.
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 $2,698Billed $12,681
About 21¢ was paid for every $1 hospitals in Rhode Island billed for this service.
Rhode Island hospitals: level 3 excision/biopsy/incision and drainage
Every Rhode Island hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Rhode Island HospitalProvidence | 107 | $13,883 | $2,738 | $2,177 |
| Kent County Memorial HospitalWarwick | 46 | $11,502 | $2,438 | $1,934 |
| Westerly HospitalWesterly | 38 | $14,661 | $2,884 | $2,296 |
| Roger Williams Medical CenterProvidence | 30 | $12,632 | $2,884 | $2,291 |
| Miriam HospitalProvidence | 22 | $9,469 | $2,490 | $1,984 |
| Newport HospitalNewport | 13 | $6,726 | $2,662 | $2,121 |
| Our Lady of Fatima HospitalNorth Providence | – | – | – | – |
| South County Hospital INCWakefield | – | – | – | – |
| Women and Infants Hospital of Rhode IslandProvidence | – | – | – | – |
| Landmark Medical Center, INCWoonsocket | – | – | – | – |
Lowest and highest allowed amounts in Rhode Island
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
| Kent County Memorial HospitalWarwick, RI | $2,438 |
|---|---|
| Miriam HospitalProvidence, RI | $2,490 |
| Newport HospitalNewport, RI | $2,662 |
| Rhode Island HospitalProvidence, RI | $2,738 |
| Westerly HospitalWesterly, RI | $2,884 |
Highest
| Roger Williams Medical CenterProvidence, RI | $2,884 |
|---|---|
| Westerly HospitalWesterly, RI | $2,884 |
| Rhode Island HospitalProvidence, RI | $2,738 |
| Newport HospitalNewport, RI | $2,662 |
| Miriam HospitalProvidence, RI | $2,490 |
Level 3 Excision/Biopsy/Incision and Drainage in other states
Questions
How much does level 3 excision/biopsy/incision and drainage cost in Rhode Island?
In 2024 Medicare data, level 3 excision/biopsy/incision and drainage (APC 5073) at 10 hospitals in Rhode Island was billed at $12,681 on average, while the average medicare-allowed amount was $2,698, of which Medicare paid $2,145. 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 Rhode Island, average charges were 4.7 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.