Level 4 Breast/Lymphatic Surgery and Related Procedures in Missouri
What 18 hospitals in Missouri charged and were paid for level 4 breast/lymphatic surgery and related procedures (APC 5094), from 2024 Medicare claims.
Average charge
$42,809
Hospital list price billed
Average allowed
$13,594
Medicare's payment + patient's share
Medicare paid
$11,962
Average per service
State rank
#1 of 23
1 = lowest average payment
Hospitals in Missouri billed an average of $42,809 for level 4 breast/lymphatic surgery and related procedures, about 3.1 times the average medicare-allowed amount of $13,594. That payment is 21% 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 $13,594Billed $42,809
About 32¢ was paid for every $1 hospitals in Missouri billed for this service.
Missouri hospitals: level 4 breast/lymphatic surgery and related procedures
Every Missouri hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Lester E Cox Medical CentersSpringfield | 11 | $42,809 | $13,594 | $11,962 |
| Mercy Hospital JoplinJoplin | – | – | – | – |
| SSM St Joseph Health CenterSt Charles | – | – | – | – |
| St John's Mercy Medical CenterSt Louis | – | – | – | – |
| Barnes Jewish HospitalSt Louis | – | – | – | – |
| Saint Luke's Northland HospSmithville | – | – | – | – |
| Mercy Hospital SpringfieldSpringfield | – | – | – | – |
| Boone Hospital CenterColumbia | – | – | – | – |
| Mercy Hospital SouthSt Louis | – | – | – | – |
| SSM St Joseph Hosp of KirkwoodSt Louis | – | – | – | – |
| St Lukes Hospital of Kansas CityKansas City | – | – | – | – |
| University Hospitals & ClinicsColumbia | – | – | – | – |
| Barnes-Jewish West County HospitalSt Louis | – | – | – | – |
| Liberty HospitalLiberty | – | – | – | – |
| St Lukes HospitalChesterfield | – | – | – | – |
| Christian Hospital NortheastSt Louis | – | – | – | – |
| Lake Regional Health SystemOsage Beach | – | – | – | – |
| Saint Luke's East Lee's Summit HospitalLee's Summit | – | – | – | – |
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 Missouri?
In 2024 Medicare data, level 4 breast/lymphatic surgery and related procedures (APC 5094) at 18 hospitals in Missouri was billed at $42,809 on average, while the average medicare-allowed amount was $13,594, of which Medicare paid $11,962. 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 Missouri, 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.