Level 4 Breast/Lymphatic Surgery and Related Procedures in South Dakota
What 4 hospitals in South Dakota charged and were paid for level 4 breast/lymphatic surgery and related procedures (APC 5094), from 2024 Medicare claims.
Average charge
$94,861
Hospital list price billed
Average allowed
$16,487
Medicare's payment + patient's share
Medicare paid
$14,855
Average per service
State rank
#15 of 23
1 = lowest average payment
Hospitals in South Dakota billed an average of $94,861 for level 4 breast/lymphatic surgery and related procedures, about 5.8 times the average medicare-allowed amount of $16,487. That payment is 4% 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 $16,487Billed $94,861
About 17¢ was paid for every $1 hospitals in South Dakota billed for this service.
South Dakota hospitals: level 4 breast/lymphatic surgery and related procedures
Every South Dakota hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Avera McKennan Hospital & University Health CenterSioux Falls | 14 | $94,861 | $16,487 | $14,855 |
| Sanford Usd Medical CenterSioux Falls | – | – | – | – |
| Rapid City Regional HospitalRapid City | – | – | – | – |
| Same Day Surgery Center LLCRapid City | – | – | – | – |
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 South Dakota?
In 2024 Medicare data, level 4 breast/lymphatic surgery and related procedures (APC 5094) at 4 hospitals in South Dakota was billed at $94,861 on average, while the average medicare-allowed amount was $16,487, of which Medicare paid $14,855. 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 South Dakota, average charges were 5.8 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.