Level 4 Breast/Lymphatic Surgery and Related Procedures in Kentucky
What 11 hospitals in Kentucky charged and were paid for level 4 breast/lymphatic surgery and related procedures (APC 5094), from 2024 Medicare claims.
Average charge
$151,920
Hospital list price billed
Average allowed
$14,052
Medicare's payment + patient's share
Medicare paid
$12,402
Average per service
State rank
#2 of 23
1 = lowest average payment
Hospitals in Kentucky billed an average of $151,920 for level 4 breast/lymphatic surgery and related procedures, about 10.8 times the average medicare-allowed amount of $14,052. That payment is 18% below 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 $14,052Billed $151,920
About 9¢ was paid for every $1 hospitals in Kentucky billed for this service.
Kentucky hospitals: level 4 breast/lymphatic surgery and related procedures
Every Kentucky hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Norton Healthcare PavilionLouisville | 13 | $151,920 | $14,052 | $12,402 |
| Saint Joseph HospitalLexington | – | – | – | – |
| The Medical Center at Bowling GreenBowling Green | – | – | – | – |
| St Elizabeth Med Center-SouthEdgewood | – | – | – | – |
| Owensboro Medical Health SystemOwensboro | – | – | – | – |
| University of Kentucky HospLexington | – | – | – | – |
| Lourdes HospitalPaducah | – | – | – | – |
| Central Baptist HospitalLexington | – | – | – | – |
| Western Baptist HospitalPaducah | – | – | – | – |
| Baptist Hospital EastLouisville | – | – | – | – |
| University of Louisville HospitalLouisville | – | – | – | – |
Level 4 Breast/Lymphatic Surgery and Related Procedures in other states
Questions
How much does level 4 breast/lymphatic surgery and related procedures cost in Kentucky?
In 2024 Medicare data, level 4 breast/lymphatic surgery and related procedures (APC 5094) at 11 hospitals in Kentucky was billed at $151,920 on average, while the average medicare-allowed amount was $14,052, of which Medicare paid $12,402. 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 Kentucky, average charges were 10.8 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.