Other skin, subcutaneous tissue and breast procedures with complications
What 84 hospitals in the U.S. charged and were paid for a Medicare hospital stay for other skin, subcutaneous tissue and breast procedures with complications (DRG 580), from 2024 Medicare claims.
Average charge
$99,591
Hospital list price billed
Average payment
$19,188
Medicare + patient + other payers
Medicare paid
$13,552
Average per stay
Volume
1,201
Medicare hospital stays
Hospitals in the U.S. billed an average of $99,591 for other skin, subcutaneous tissue and breast procedures with complications, about 5.2 times the average total payment of $19,188.
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 $19,188Billed $99,591
About 19¢ was paid for every $1 hospitals in the U.S. billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them:
Lowest and highest payments
Among hospitals with at least 20 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Delray Medical CenterDelray Beach, FL | $8,624 |
|---|---|
| Sarasota Memorial HospitalSarasota, FL | $12,897 |
| Norton Healthcare PavilionLouisville, KY | $13,554 |
| Blake Medical CenterBradenton, FL | $15,254 |
| Methodist HospitalSan Antonio, TX | $16,019 |
| Adventhealth OrlandoOrlando, FL | $17,148 |
| University HospitalStony Brook, NY | $19,891 |
| New York-Presbyterian HospitalNew York, NY | $21,425 |
Highest
| New York-Presbyterian HospitalNew York, NY | $21,425 |
|---|---|
| University HospitalStony Brook, NY | $19,891 |
| Adventhealth OrlandoOrlando, FL | $17,148 |
| Methodist HospitalSan Antonio, TX | $16,019 |
| Blake Medical CenterBradenton, FL | $15,254 |
| Norton Healthcare PavilionLouisville, KY | $13,554 |
| Sarasota Memorial HospitalSarasota, FL | $12,897 |
| Delray Medical CenterDelray Beach, FL | $8,624 |
Other skin, subcutaneous tissue and breast procedures with complications cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg payment | Range |
|---|---|---|---|---|
| Alabama | 1 | $103,039 | $18,369 | – |
| Arizona | 2 | $96,682 | $24,931 | $15,037 – $33,079 |
| Arkansas | 1 | $62,400 | $17,960 | – |
| California | 8 | $182,652 | $28,077 | $17,064 – $47,553 |
| Colorado | 1 | $84,551 | $13,168 | – |
| Delaware | 1 | $45,312 | $15,697 | – |
| Florida | 8 | $117,558 | $14,532 | $8,624 – $17,772 |
| Georgia | 1 | $78,914 | $16,023 | – |
| Illinois | 1 | $124,744 | $54,308 | – |
| Indiana | 1 | $46,800 | $12,430 | – |
| Kansas | 1 | $102,434 | $16,374 | – |
| Kentucky | 2 | $71,183 | $15,082 | $13,554 – $18,556 |
| Louisiana | 2 | $157,977 | $19,074 | $10,548 – $27,600 |
| Maryland | 1 | $18,558 | $17,152 | – |
| Massachusetts | 3 | $69,926 | $21,386 | $20,516 – $22,004 |
| Michigan | 4 | $76,831 | $18,453 | $14,237 – $22,722 |
| Minnesota | 2 | $69,009 | $25,295 | $14,908 – $32,219 |
| Mississippi | 1 | $62,001 | $12,854 | – |
| Missouri | 2 | $55,442 | $15,809 | $12,813 – $18,805 |
| Nebraska | 1 | $40,812 | $13,428 | – |
| Nevada | 2 | $140,169 | $17,167 | $15,786 – $18,272 |
| New Jersey | 2 | $145,048 | $27,444 | $17,191 – $35,539 |
| New York | 7 | $122,202 | $21,378 | $14,480 – $27,665 |
| North Carolina | 4 | $60,290 | $16,429 | $12,578 – $22,548 |
| North Dakota | 1 | $44,477 | $14,121 | – |
| Ohio | 4 | $63,448 | $15,241 | $12,793 – $20,618 |
| Oklahoma | 4 | $76,059 | $15,133 | $12,219 – $19,955 |
| Pennsylvania | 2 | $130,501 | $16,320 | $15,383 – $17,854 |
| Rhode Island | 1 | $62,392 | $20,604 | – |
| South Carolina | 2 | $80,919 | $19,588 | $16,005 – $24,663 |
| South Dakota | 1 | $64,875 | $14,966 | – |
| Tennessee | 1 | $100,767 | $20,251 | – |
| Texas | 2 | $128,838 | $15,709 | $15,018 – $16,019 |
| Utah | 1 | $39,239 | $18,543 | – |
| Virginia | 3 | $78,382 | $18,480 | $13,245 – $24,318 |
| Washington | 1 | $91,609 | $23,983 | – |
| Wisconsin | 2 | $61,883 | $15,911 | $13,712 – $17,334 |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| Methodist HospitalSan Antonio, TX | 29 | $153,451 | $16,019 |
| New York-Presbyterian HospitalNew York, NY | 26 | $143,033 | $21,425 |
| Norton Healthcare PavilionLouisville, KY | 25 | $78,119 | $13,554 |
| Sarasota Memorial HospitalSarasota, FL | 22 | $106,791 | $12,897 |
| University HospitalStony Brook, NY | 22 | $109,917 | $19,891 |
| Adventhealth OrlandoOrlando, FL | 21 | $115,100 | $17,148 |
| Blake Medical CenterBradenton, FL | 21 | $137,723 | $15,254 |
| Delray Medical CenterDelray Beach, FL | 20 | $139,733 | $8,624 |
| Morristown Memorial HospitalMorristown, NJ | 19 | $160,649 | $35,539 |
| Christiana Care Health Services, INC.Newark, DE | 18 | $45,312 | $15,697 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | 18 | $76,554 | $32,219 |
| NYU Hospitals CenterNew York, NY | 18 | $209,221 | $27,665 |
| Lehigh Valley HospitalAllentown, PA | 18 | $119,021 | $15,383 |
| Mayo Clinic HospitalPhoenix, AZ | 17 | $105,147 | $33,079 |
| Memorial Hospital CentralColorado Springs, CO | 17 | $84,551 | $13,168 |
Questions
How much does other skin, subcutaneous tissue and breast procedures with complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for other skin, subcutaneous tissue and breast procedures with complications (DRG 580) at 84 hospitals in the U.S. was billed at $99,591 on average, while the average total payment was $19,188, of which Medicare paid $13,552. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for other skin, subcutaneous tissue and breast procedures with complications?
Among states with at least three hospitals reporting, the average total payment was highest in California ($28,077), Massachusetts ($21,386), New York ($21,378) and lowest in Florida ($14,532), Oklahoma ($15,133), Ohio ($15,241).
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 stay in the U.S., average charges were 5.2 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.
Source: CMS, Medicare Inpatient Hospitals by Provider and Service, 2024. Average total payment includes Medicare's payment, the patient's deductible and coinsurance, and any other payer. CMS omits hospitals with fewer than 11 hospital stays for privacy. About the data.