facebook tracking Level 4 Breast/Lymphatic Surgery and Related Procedures cost in Michigan: 23 hospitals compared (APC 5094)

Level 4 Breast/Lymphatic Surgery and Related Procedures in Michigan

What 23 hospitals in Michigan 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 $50,734 Hospital list price billed
Average allowed $16,268 Medicare's payment + patient's share
Medicare paid $14,636 Average per service
State rank #14 of 23 1 = lowest average payment

Hospitals in Michigan billed an average of $50,734 for level 4 breast/lymphatic surgery and related procedures, about 3.1 times the average medicare-allowed amount of $16,268. That payment is 5% 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 $16,268Billed $50,734

About 32¢ was paid for every $1 hospitals in Michigan billed for this service.

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

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

Hospital Services Avg charge Avg allowed Medicare paid
Univ of Michigan HospitalsAnn Arbor 11 $50,734 $16,268 $14,636
St Mary Mercy HospitalLivonia – – – –
Providence Hospital and Medical CentersSouthfield – – – –
Lakeland Hospital, St JosephSt Joseph – – – –
St Joseph Mercy OaklandPontiac – – – –
Spectrum Health - Butterworth CampusGrand Rapids – – – –
Henry Ford Macomb HospitalClinton Twp – – – –
Henry Ford HospitalDetroit – – – –
Saint Mary's Health CareGrand Rapids – – – –
Trinity Health Muskegon HospitalMuskegon – – – –
Beaumont Hospital, Grosse PointeGrosse Pointe – – – –
Munson Medical CenterTraverse City – – – –
Borgess Medical CenterKalamazoo – – – –
William Beaumont HospitalRoyal Oak – – – –
Hurley Medical CenterFlint – – – –
Beaumont Hospital - Farmington HillsFarmington Hls – – – –
Trinity Health Ann Arbor HospitalAnn Arbor – – – –
St John Hospital and Medical CenterDetroit – – – –
Corewell Health Trenton HospitalTrenton – – – –
McLaren MacombMt Clemens – – – –
Chelsea Community HospitalChelsea – – – –
William Beaumont Hospital-TroyTroy – – – –
Huron Valley-Sinai HospitalCommerce Twp – – – –
Level 4 Breast/Lymphatic Surgery and Related Procedures: all states All Michigan hospitals Michigan hospital finances
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Level 4 Breast/Lymphatic Surgery and Related Procedures in other states

Arizona · $16,500 Florida · $15,930 Georgia · $15,586 Illinois · $16,689 Kansas · $15,416 South Dakota · $16,487 Texas · $15,873 Virginia · $15,429

Questions

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

In 2024 Medicare data, level 4 breast/lymphatic surgery and related procedures (APC 5094) at 23 hospitals in Michigan was billed at $50,734 on average, while the average medicare-allowed amount was $16,268, of which Medicare paid $14,636. 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 Michigan, average charges were 3.1 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.