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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

Hospitals in Texas

Narrow by a state, city or ZIP code (optionally a distance around it), and/or pick specific hospitals. With both, your picks are added to the area’s hospitals.

Location
Texas
Specific hospitals up to 10
Average payment across these 71 hospitals
$3,388National $3,688 · Texas $3,405
Median hospital
$3,406
Lowest to highest
$3,196–$3,558
Medicare procedures
1,969

71 hospitals reported at least 11 Medicare procedures for this in 2024; showing 51–71. Download as CSV

Medicare payments per case for Level 1 Breast/Lymphatic Surgery and Related Procedures by hospital, 2024
HospitalCasesAverage paymentvs national averageMedicare paidBilled charge
Medical City LewisvilleLewisville, TX · CCN 45066918$3,441About average$2,742$68,280
Methodist Mansfield Medical CenterMansfield, TX · CCN 67002311$3,441About average$2,742$16,052
Methodist Southlake Medical CenterSouthlake, TX · CCN 67013212$3,441About average$2,742$20,004
Texas Health Harris Methodist Hospital SouthlakeSouthlake, TX · CCN 45088817$3,441About average$2,742$14,832
Texas Health Harris Methodist Hospital Southwest FFort Worth, TX · CCN 45077927$3,441About average$2,742$18,320
Texas Health Harris Methodist Hurst-Euless-BedfordBedford, TX · CCN 45063923$3,441About average$2,742$16,167
Texas Health Presbyterian Hospital DentonDenton, TX · CCN 45074319$3,441About average$2,742$21,933
Texas Health Presbyterian Hospital Flower MoundFlower Mound, TX · CCN 67006811$3,441About average$2,742$19,834
Texas Health Arlington Memorial HospitalArlington, TX · CCN 45006415$3,441About average$2,738$18,795
Texas Health Huguley Hospital Fort Worth SouthFort Worth, TX · CCN 45067711$3,442About average$2,722$27,685
Hendrick Medical CenterAbilene, TX · CCN 45022939$3,447About average$2,732$42,465
Houston Methodist HospitalHouston, TX · CCN 45035866$3,450About average$2,726$38,859
Memorial Hermann Hospital SystemHouston, TX · CCN 45018463$3,490About average$2,771$30,252
HCA Houston Healthcare Clear LakeWebster, TX · CCN 45061720$3,534About average$2,816$76,870
Houston Methodist Sugarland HospitalSugar Land, TX · CCN 45082036$3,534About average$2,816$45,043
Houston Methodist The Woodlands HospitalThe Woodlands, TX · CCN 67012220$3,534About average$2,816$45,704
Houston Methodist West HospitalHouston, TX · CCN 67007721$3,534About average$2,816$37,717
Houston Methodist Willowbrook HospitalHouston, TX · CCN 45084420$3,534About average$2,816$52,421
Memorial Hermann Memorial City HospitalHouston, TX · CCN 45061018$3,534About average$2,816$36,810
Memorial Hermann Sugar Land HospitalSugar Land, TX · CCN 45084813$3,534About average$2,816$35,582
United Regional Health Care SystemWichita Falls, TX · CCN 45001019$3,558About average$2,835$12,120

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 careAverage paymentAverage 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
StateHospitalsCasesAverage paymentTypical range
Vermont4115$1,751$1,218–$2,043
Alabama22584$3,114$3,044–$3,182
Louisiana18431$3,169$3,101–$3,229
Mississippi16435$3,173$3,113–$3,191
Tennessee23894$3,183$3,144–$3,284
West Virginia11320$3,207$3,102–$3,230
Arkansas13346$3,247$3,119–$3,267
Ohio511,821$3,250$3,243–$3,337
South Carolina281,263$3,257$3,185–$3,289
Oklahoma14500$3,261$3,228–$3,284
Kentucky17677$3,266$3,247–$3,301
Missouri301,011$3,289$3,206–$3,392
Kansas13417$3,311$3,315–$3,329
Iowa13411$3,338$3,273–$3,435
Georgia371,276$3,368$3,266–$3,537
Michigan381,316$3,370$3,321–$3,404
Florida703,443$3,379$3,442–$3,453
North Carolina341,510$3,383$3,317–$3,430
Virginia361,673$3,395$3,248–$3,506
Texas722,262$3,405$3,318–$3,441
Utah8301$3,416$3,339–$3,475
New Mexico8199$3,419$3,303–$3,431
Nebraska10365$3,425$3,435–$3,451
Maine6222$3,457$3,432–$3,581
Indiana30805$3,463$3,407–$3,517
Pennsylvania672,424$3,508$3,405–$3,677
Wisconsin26687$3,529$3,464–$3,585
Idaho8191$3,536$3,430–$3,674
South Dakota7246$3,563$3,539–$3,701
Illinois531,955$3,603$3,523–$3,622
North Dakota5213$3,615$3,574–$3,827
Colorado23558$3,624$3,629–$3,629
Montana8259$3,630$3,574–$3,745
Arizona241,201$3,717$3,682–$3,717
Wyoming575$3,731$3,753–$3,827
Minnesota16709$3,743$3,644–$3,800
New Hampshire10352$3,744$3,655–$3,776
Delaware4330$3,811$3,817–$3,827
Rhode Island6190$3,843$3,868–$3,868
District of Columbia4254$3,864$3,863–$3,900
Washington291,036$3,892$3,826–$3,927
Alaska382$3,957$3,822–$4,074
Nevada9269$3,997$3,805–$4,082
Oregon17526$4,027$3,917–$4,165
New Jersey361,473$4,070$3,986–$4,143
Massachusetts382,257$4,080$4,085–$4,094
New York583,824$4,207$4,041–$4,295
Connecticut17601$4,260$4,252–$4,293
Hawaii5147$4,353$4,320–$4,384
California843,896$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.