Outpatient procedure · APC 5091 · Surgery or procedure

Level 1 Breast/Lymphatic Surgery and Related Procedures

In 2024, Medicare and patients paid an average of $3,688 per procedure at 1,184 hospitals. Half of hospitals averaged between $3,320 and $3,848.

Also known as: Lumpectomy, mastectomy, breast surgery

National figures, 2024

Average payment per case: $3,688
Typical range (middle half of hospitals): $3,320–$3,848
Medicare’s share: $2,93079% of the payment
Average billed charge: $27,785
Hospitals reporting: 1,18446,352 procedures

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1,176 hospitals reported at least 11 Medicare procedures for this in 2024; showing 1–50. Download as CSV

Medicare payments per case for Level 1 Breast/Lymphatic Surgery and Related Procedures by hospital, 2024
Hospital	Cases	Average payment	vs national average	Medicare paid	Billed charge
Central Vermont Medical CenterBarre, VT · CCN 470001	16	$1,145	69% below the national average	$377	$11,820
Rutland Regional Medical CenterRutland, VT · CCN 470005	12	$1,243	66% below the national average	$491	$17,320
MetroHealth SystemCleveland, OH · CCN 360059	18	$1,526	59% below the national average	$864	$18,412
Geisinger-Lewistown HospitalLewistown, PA · CCN 390048	20	$1,819	51% below the national average	$1,449	$25,532
University Of Vermont - Fletcher Allen Health CareBurlington, VT · CCN 470003	76	$1,819	51% below the national average	$1,059	$11,326
UPMC MemorialYork, PA · CCN 390101	22	$1,838	50% below the national average	$1,454	$18,415
Baptist Memorial Hospital - Carroll CountyHuntingdon, TN · CCN 440016	22	$1,872	49% below the national average	$1,491	$13,966
Marietta Memorial HospitalMarietta, OH · CCN 360147	25	$2,107	43% below the national average	$1,441	$20,202
SSM St Joseph Health CenterSaint Charles, MO · CCN 260005	19	$2,507	32% below the national average	$1,980	$13,586
Lee Memorial HospitalFort Myers, FL · CCN 100012	207	$2,532	31% below the national average	$2,017	$40,934
Piedmont Medical CenterRock Hill, SC · CCN 420002	23	$2,595	30% below the national average	$1,888	$34,007
Gettysburg HospitalGettysburg, PA · CCN 390065	23	$2,678	27% below the national average	$2,134	$12,786
Southwestern Vermont Medical CenterBennington, VT · CCN 470012	11	$2,716	26% below the national average	$1,939	$18,696
Baptist Health Brookwood HospitalBirmingham, AL · CCN 010139	32	$2,798	24% below the national average	$2,151	$53,061
Memorial Hospital At GulfportGulfport, MS · CCN 250019	30	$2,817	24% below the national average	$2,245	$23,795
Johnston HealthSmithfield, NC · CCN 340090	14	$2,844	23% below the national average	$2,147	$22,524
Grandview Medical CenterBirmingham, AL · CCN 010104	28	$2,876	22% below the national average	$2,231	$119,156
Magee Womens Hospital Of UPMC Health SystemPittsburgh, PA · CCN 390114	82	$2,923	21% below the national average	$2,321	$26,938
Vanderbilt University Medical CenterNashville, TN · CCN 440039	104	$2,978	19% below the national average	$2,367	$28,946
Parma Community General HospitalParma, OH · CCN 360041	19	$2,981	19% below the national average	$2,320	$22,264
Marshall Medical CentersBoaz, AL · CCN 010005	14	$2,985	19% below the national average	$2,343	$7,628
St Vincent's BirminghamBirmingham, AL · CCN 010056	14	$3,001	19% below the national average	$2,354	$32,963
St Joseph's Hospital - SavannahSavannah, GA · CCN 110043	11	$3,007	18% below the national average	$2,353	$18,968
St Tammany Parish HospitalCovington, LA · CCN 190045	25	$3,023	18% below the national average	$2,367	$17,961
St Marys Medical CenterHuntington, WV · CCN 510007	12	$3,031	18% below the national average	$2,371	$14,445
Lewisgale Medical CenterSalem, VA · CCN 490048	21	$3,032	18% below the national average	$2,365	$62,062
Callahan Eye HospitalBirmingham, AL · CCN 010018	69	$3,035	18% below the national average	$2,388	$11,999
University Of Alabama HospitalBirmingham, AL · CCN 010033	36	$3,041	18% below the national average	$2,394	$39,954
Delta Health System - The Medical CenterGreenville, MS · CCN 250082	16	$3,045	17% below the national average	$2,351	$9,677
Edward W Sparrow HospitalLansing, MI · CCN 230230	29	$3,047	17% below the national average	$2,372	$22,938
Charleston Area Medical CenterCharleston, WV · CCN 510022	42	$3,047	17% below the national average	$2,387	$24,557
Geisinger Wyoming Valley Medical CenterWilkes Barre, PA · CCN 390270	42	$3,048	17% below the national average	$2,415	$59,486
St Francis-DowntownGreenville, SC · CCN 420023	33	$3,050	17% below the national average	$2,382	$25,249
North Alabama Medical CenterFlorence, AL · CCN 010006	23	$3,054	17% below the national average	$2,433	$29,751
St Dominic-Jackson Memorial HospitalJackson, MS · CCN 250048	42	$3,054	17% below the national average	$2,418	$17,531
Baptist Memorial Hospital Jonesboro, Inc.Jonesboro, AR · CCN 040118	17	$3,065	17% below the national average	$2,404	$13,677
Wellstar McG Health, Affiliated With Medical ColAugusta, GA · CCN 110034	16	$3,065	17% below the national average	$2,409	$31,570
Fmol Health St FrancisMonroe, LA · CCN 190125	25	$3,068	17% below the national average	$2,424	$14,114
Mobile Infirmary Medical CenterMobile, AL · CCN 010113	29	$3,074	17% below the national average	$2,431	$7,153
East Jefferson General HospitalMetairie, LA · CCN 190176	17	$3,077	17% below the national average	$2,421	$70,323
St Elizabeth EdgewoodEdgewood, KY · CCN 180035	64	$3,078	17% below the national average	$2,408	$17,778
Thomas Memorial HospitalSouth Charleston, WV · CCN 510029	17	$3,080	17% below the national average	$2,423	$21,544
Ochsner Lafayette General Medical CenterLafayette, LA · CCN 190002	29	$3,082	16% below the national average	$2,438	$17,992
Roper St Francis Hospital-Berkeley IncSummerville, SC · CCN 420110	24	$3,084	16% below the national average	$2,413	$20,973
Memorial HealthLawton, OK · CCN 370056	17	$3,085	16% below the national average	$2,427	$26,970
Good Samaritan Medical CenterWest Palm Beach, FL · CCN 100287	68	$3,089	16% below the national average	$2,387	$73,741
Baptist Health - Fort SmithFort Smith, AR · CCN 040055	17	$3,090	16% below the national average	$2,431	$25,207
Archbold Memorial HospitalThomasville, GA · CCN 110038	15	$3,094	16% below the national average	$2,430	$14,651
Womans HospitalBaton Rouge, LA · CCN 190128	41	$3,098	16% below the national average	$2,443	$14,829
Mercy Hospital JoplinJoplin, MO · CCN 260001	20	$3,103	16% below the national average	$2,452	$11,727

National trend

Average payment and billed charge per procedure, and how many Medicare procedures were reported each year.

Average payment
Average billed charge

2020: 42,760 procedures at 1,278 hospitals · 2021: 45,301 procedures at 1,261 hospitals · 2022: 44,625 procedures at 1,226 hospitals · 2023: 45,351 procedures at 1,191 hospitals · 2024: 46,352 procedures at 1,184 hospitals

View data as a table

National average payment and billed charge for Level 1 Breast/Lymphatic Surgery and Related Procedures
Year of care	Average payment	Average billed charge
2020	$3,050	$22K
2021	$3,208	$23K
2022	$3,243	$24K
2023	$3,449	$26K
2024	$3,688	$28K

By state, 2024

Case-weighted average payment across each state’s reporting hospitals, lowest first.

Show all 50 states

Average payment by state for Level 1 Breast/Lymphatic Surgery and Related Procedures, 2024
State	Hospitals	Cases	Average payment	Typical range
Vermont	4	115	$1,751	$1,218–$2,043
Alabama	22	584	$3,114	$3,044–$3,182
Louisiana	18	431	$3,169	$3,101–$3,229
Mississippi	16	435	$3,173	$3,113–$3,191
Tennessee	23	894	$3,183	$3,144–$3,284
West Virginia	11	320	$3,207	$3,102–$3,230
Arkansas	13	346	$3,247	$3,119–$3,267
Ohio	51	1,821	$3,250	$3,243–$3,337
South Carolina	28	1,263	$3,257	$3,185–$3,289
Oklahoma	14	500	$3,261	$3,228–$3,284
Kentucky	17	677	$3,266	$3,247–$3,301
Missouri	30	1,011	$3,289	$3,206–$3,392
Kansas	13	417	$3,311	$3,315–$3,329
Iowa	13	411	$3,338	$3,273–$3,435
Georgia	37	1,276	$3,368	$3,266–$3,537
Michigan	38	1,316	$3,370	$3,321–$3,404
Florida	70	3,443	$3,379	$3,442–$3,453
North Carolina	34	1,510	$3,383	$3,317–$3,430
Virginia	36	1,673	$3,395	$3,248–$3,506
Texas	72	2,262	$3,405	$3,318–$3,441
Utah	8	301	$3,416	$3,339–$3,475
New Mexico	8	199	$3,419	$3,303–$3,431
Nebraska	10	365	$3,425	$3,435–$3,451
Maine	6	222	$3,457	$3,432–$3,581
Indiana	30	805	$3,463	$3,407–$3,517
Pennsylvania	67	2,424	$3,508	$3,405–$3,677
Wisconsin	26	687	$3,529	$3,464–$3,585
Idaho	8	191	$3,536	$3,430–$3,674
South Dakota	7	246	$3,563	$3,539–$3,701
Illinois	53	1,955	$3,603	$3,523–$3,622
North Dakota	5	213	$3,615	$3,574–$3,827
Colorado	23	558	$3,624	$3,629–$3,629
Montana	8	259	$3,630	$3,574–$3,745
Arizona	24	1,201	$3,717	$3,682–$3,717
Wyoming	5	75	$3,731	$3,753–$3,827
Minnesota	16	709	$3,743	$3,644–$3,800
New Hampshire	10	352	$3,744	$3,655–$3,776
Delaware	4	330	$3,811	$3,817–$3,827
Rhode Island	6	190	$3,843	$3,868–$3,868
District of Columbia	4	254	$3,864	$3,863–$3,900
Washington	29	1,036	$3,892	$3,826–$3,927
Alaska	3	82	$3,957	$3,822–$4,074
Nevada	9	269	$3,997	$3,805–$4,082
Oregon	17	526	$4,027	$3,917–$4,165
New Jersey	36	1,473	$4,070	$3,986–$4,143
Massachusetts	38	2,257	$4,080	$4,085–$4,094
New York	58	3,824	$4,207	$4,041–$4,295
Connecticut	17	601	$4,260	$4,252–$4,293
Hawaii	5	147	$4,353	$4,320–$4,384
California	84	3,896	$4,851	$4,686–$4,924

About these numbers

Average payment is what Medicare paid plus the patient’s deductible and coinsurance (and any other insurer), averaged over the hospital’s Medicare cases. It covers the hospital’s part of the care; doctors bill separately. For outpatient procedures it is Medicare’s allowed amount, which leaves out extra “outlier” payments for unusually costly cases; those are shown under the hospital name where CMS reported any, and included in the CSV. Billed charges are the hospital’s list prices, which few patients pay.

Medicare sets its payments by formula, adjusting for local wages, teaching programs, the share of low-income patients and unusually costly cases. Those adjustments drive most differences between hospitals, so a lower payment doesn’t mean better or worse care, and Medicare patients’ own costs usually vary much less than the totals. Private insurance pays different, usually higher, prices.

Source: CMS Medicare Outpatient Hospitals by Provider and Service (Medicare fee-for-service claims). CMS omits hospitals with fewer than 11 procedures. More in the glossary.