Level 4 Breast/Lymphatic Surgery and Related Procedures in Massachusetts
What 16 hospitals in Massachusetts charged and were paid for level 4 breast/lymphatic surgery and related procedures (APC 5094), from 2024 Medicare claims.
Average charge
$64,361
Hospital list price billed
Average allowed
$18,881
Medicare's payment + patient's share
Medicare paid
$17,249
Average per service
State rank
#20 of 23
1 = lowest average payment
Hospitals in Massachusetts billed an average of $64,361 for level 4 breast/lymphatic surgery and related procedures, about 3.4 times the average medicare-allowed amount of $18,881. That payment is 10% 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 $18,881Billed $64,361
About 29¢ was paid for every $1 hospitals in Massachusetts billed for this service.
Massachusetts hospitals: level 4 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 |
|---|---|---|---|---|
| Faulkner HospitalBoston | 29 | $64,361 | $18,881 | $17,249 |
| Mount Auburn HospitalCambridge | – | – | – | – |
| Cape Cod HospitalHyannis | – | – | – | – |
| Beverly Hospital CorporationBeverly | – | – | – | – |
| Brockton HospitalBrockton | – | – | – | – |
| Beth Israel Deaconess Hospital PlymouthPlymouth | – | – | – | – |
| Melrosewakefield HealthcareMelrose | – | – | – | – |
| Massachusetts General HospitalBoston | – | – | – | – |
| Baystate Medical CenterSpringfield | – | – | – | – |
| Beth Israel Deaconess Medical CenterBoston | – | – | – | – |
| South Shore HospitalSouth Weymouth | – | – | – | – |
| Newton-Wellesley HospitalNewton Lower Falls | – | – | – | – |
| Brigham and Women's HosptialBoston | – | – | – | – |
| Tufts Medical CenterBoston | – | – | – | – |
| Umass Memorial Medical Center INCWorcester | – | – | – | – |
| Lahey Clinic HospitalBurlington | – | – | – | – |
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 Massachusetts?
In 2024 Medicare data, level 4 breast/lymphatic surgery and related procedures (APC 5094) at 16 hospitals in Massachusetts was billed at $64,361 on average, while the average medicare-allowed amount was $18,881, of which Medicare paid $17,249. 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 3.4 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.