facebook tracking Level 4 Breast/Lymphatic Surgery and Related Procedures cost in California: 84 hospitals compared (APC 5094)

Level 4 Breast/Lymphatic Surgery and Related Procedures in California

What 84 hospitals in California charged and were paid for level 4 breast/lymphatic surgery and related procedures (APC 5094), from 2024 Medicare claims.

APC 5094 Outpatient 2024 Medicare data
Average charge $192,881 Hospital list price billed
Average allowed $21,610 Medicare's payment + patient's share
Medicare paid $19,978 Average per service
State rank #23 of 23 1 = lowest average payment

Hospitals in California billed an average of $192,881 for level 4 breast/lymphatic surgery and related procedures, about 8.9 times the average medicare-allowed amount of $21,610. That payment is 26% above the U.S. average of $17,182.

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 $21,610Billed $192,881

About 11¢ was paid for every $1 hospitals in California billed for this service.

California hospitals: level 4 breast/lymphatic surgery and related procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
Scripps Memorial Hospital la JollaLa Jolla 22 $198,575 $21,610 $19,978
Sharp Memorial HospitalSan Diego 15 $112,893 $21,610 $19,978
Cedars-Sinai Medical CenterLos Angeles 15 $264,517 $21,610 $19,978
Peninsula Medical CenterBurlingame – – – –
California Pacific Medical Ctr-Davies Campus HospSan Francisco – – – –
Queen of the Valley Medical CenterNapa – – – –
St Helena HospitalDeer Park – – – –
Mercy General HospitalSacramento – – – –
Riverside Community HospitalRiverside – – – –
University of California San Diego Medical CenterSan Diego – – – –
Grossmont HospitalLa Mesa – – – –
Bakersfield Memorial HospitalBakersfield – – – –
Enloe Medical CenterChico – – – –
Kaweah Delta Medical CenterVisalia – – – –
Community Regional Medical CenterFresno – – – –
Saint Agnes Medical CenterFresno – – – –
Sutter General HospitalSacramento – – – –
Santa Monica - UCLA Med Ctr & Orthopaedic HospitalSanta Monica – – – –
Valley Presbyterian HospitalVan Nuys – – – –
Tri-City Medical CenterOceanside – – – –
Novato Community HospitalNovato – – – –
Community Hospital of the Monterey PeninsulaMonterey – – – –
City of Hope Natl Medical CtrDuarte – – – –
Saint Francis Memorial HospitalSan Francisco – – – –
St Jude Medical CenterFullerton – – – –
PIH Health Hospital-WhittierWhittier – – – –
Santa Rosa Memorial HospitalSanta Rosa – – – –
John Muir Medical Center - Walnut Creek CampusWalnut Creek – – – –
Sequoia HospitalRedwood City – – – –
Hoag Memorial Hospital PresbyterianNewport Beach – – – –
Glendale Adventist Medical CtrGlendale – – – –
Dominican HospitalSanta Cruz – – – –
Desert Regional Medical CenterPalm Springs – – – –
UCLA Medical CenterLos Angeles – – – –
Redlands Community HospitalRedlands – – – –
Mercy Medical Center ReddingRedding – – – –
Stanford Health Care Tri-ValleyPleasanton – – – –
Saint John's Health CenterSanta Monica – – – –
Mercy HospitalBakersfield – – – –
El Camino HospitalMountain View – – – –
Sutter Roseville Medical CenterRoseville – – – –
Loma Linda University Medical CenterLoma Linda – – – –
Salinas Valley Memorial HospitalSalinas – – – –
UCI Health-OrangeOrange – – – –
Torrance Memorial Medical CenterTorrance – – – –
Goleta Valley Cottage HospitalSanta Barbara – – – –
Marinhealth Medical CenterGreenbrae – – – –
Northbay Medical CenterFairfield – – – –
Good Samaritan HospitalSan Jose – – – –
Santa Barbara Cottage HospitalSanta Barbara – – – –
Kaiser Foundation Hospital - Harbor CityHarbor City – – – –
Mercy Hospital of FolsomFolsom – – – –
Scripps Green HospitalLa Jolla – – – –
Huntington Memorial HospitalPasadena – – – –
Stanford HospitalPalo Alto – – – –
UCSF Medical CenterSan Francisco – – – –
Adventist Health BakersfieldBakersfield – – – –
St Mary's Medical CenterSan Francisco – – – –
Doctors Medical CenterModesto – – – –
Long Beach Memorial Medical CenterLong Beach – – – –
Clovis Community Medical CenterClovis – – – –
Scripps Memorial Hospital - EncinitasEncinitas – – – –
Sierra Vista Regional Medical CenterSan Luis Obispo – – – –
Kaiser Foundation Hospital - San DiegoSan Diego – – – –
Mercy San Juan Medical CenterCarmichael – – – –
John F Kennedy Memorial HospIndio – – – –
Sutter Davis HospitalDavis – – – –
Los Robles Hospital & Medical CenterThousand Oaks – – – –
Memorial Medical CenterModesto – – – –
Mission Hospital Regional Med CenterMission Viejo – – – –
Fountain Valley Regional Hospital & Medical CenterFountain Valley – – – –
Eisenhower Memorial HospitalRancho Mirage – – – –
Methodist Hospital of SacramentoSacramento – – – –
University of California Davis Medical CenterSacramento – – – –
Saddleback Memorial Medical CenterLaguna Hills – – – –
Henry Mayo Newhall Memorial HospitalValencia – – – –
Palomar Medical Center PowayPoway – – – –
Kaiser Foundation Hosp So SacramentoSacramento – – – –
Orange Coast Memorial Medical CenterFountain Valley – – – –
Sutter Maternity & Surgery Center of Santa CruzSanta Cruz – – – –
Garfield Medical CenterMonterey Park – – – –
Providence Tarzana Medical CenterTarzana – – – –
Kaiser Foundation Hospital-Moreno ValleyMoreno Valley – – – –
Sutter Surgical Hospital - North ValleyYuba City – – – –
Level 4 Breast/Lymphatic Surgery and Related Procedures: all states All California hospitals California hospital finances
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Lowest and highest allowed amounts in California

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

Sharp Memorial HospitalSan Diego, CA$21,610
Scripps Memorial Hospital la JollaLa Jolla, CA$21,610
Cedars-Sinai Medical CenterLos Angeles, CA$21,610

Highest

Sharp Memorial HospitalSan Diego, CA$21,610
Scripps Memorial Hospital la JollaLa Jolla, CA$21,610
Cedars-Sinai Medical CenterLos Angeles, CA$21,610

Level 4 Breast/Lymphatic Surgery and Related Procedures in other states

Arizona · $16,500 Delaware · $17,641 Illinois · $16,689 Massachusetts · $18,881 Minnesota · $17,377 New Jersey · $19,036 New York · $19,850 South Dakota · $16,487

Questions

How much does level 4 breast/lymphatic surgery and related procedures cost in California?

In 2024 Medicare data, level 4 breast/lymphatic surgery and related procedures (APC 5094) at 84 hospitals in California was billed at $192,881 on average, while the average medicare-allowed amount was $21,610, of which Medicare paid $19,978. 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 California, average charges were 8.9 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.