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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 Indiana

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
Indiana
Specific hospitals up to 10
Average payment across these 30 hospitals
$3,463National $3,688 · Indiana $3,463
Median hospital
$3,443
Lowest to highest
$3,244–$3,639
Medicare procedures
805

30 hospitals reported at least 11 Medicare procedures for this in 2024. 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
Memorial Hospital Of South BendSouth Bend, IN · CCN 15005814$3,24412% below the national average$2,545$16,069
Ascension St Vincent CarmelCarmel, IN · CCN 15015734$3,362About average$2,662$52,459
Ascension St Vincent EvansvilleEvansville, IN · CCN 15010051$3,398About average$2,707$27,894
Baptist Health FloydNew Albany, IN · CCN 15004425$3,398About average$2,707$32,319
Deaconess Hospital IncEvansville, IN · CCN 15008241$3,398About average$2,707$21,437
The Women's HospitalNewburgh, IN · CCN 15014936$3,398About average$2,705$15,553
Indiana University Health Arnett HospitalLafayette, IN · CCN 15017312$3,398About average$2,707$29,881
Northwest Health - PorterValparaiso, IN · CCN 15003528$3,400About average$2,709$33,157
Ascension St Vincent HospitalIndianapolis, IN · CCN 15008420$3,426About average$2,730$35,533
Indiana University Health North HospitalCarmel, IN · CCN 15016135$3,433About average$2,730$27,938
Community Hospital NorthIndianapolis, IN · CCN 15016911$3,443About average$2,743$29,196
Community Hospital Of Anderson And Madison CountyAnderson, IN · CCN 15011321$3,443About average$2,743$23,895
Hendricks Regional HealthDanville, IN · CCN 15000518$3,443About average$2,743$32,230
Indiana University Health Bloomington HospitalBloomington, IN · CCN 15005127$3,443About average$2,743$26,711
Union Hospital IncTerre Haute, IN · CCN 15002331$3,443About average$2,743$27,922
Witham Health ServicesLebanon, IN · CCN 15010416$3,443About average$2,743$17,810
IU Health West HospitalAvon, IN · CCN 15015814$3,443About average$2,730$36,345
Hancock Regional HospitalGreenfield, IN · CCN 15003719$3,443About average$2,726$11,565
Lutheran Hospital Of IndianaFort Wayne, IN · CCN 15001714$3,448About average$2,747$39,626
Dupont Hospital LLCFort Wayne, IN · CCN 15015016$3,461About average$2,757$52,842
Indiana University HealthIndianapolis, IN · CCN 15005637$3,473About average$2,767$32,590
Columbus Regional HospitalColumbus, IN · CCN 15011219$3,507About average$2,784$15,604
Goshen HospitalGoshen, IN · CCN 15002640$3,520About average$2,804$19,450
Parkview Regional Medical CenterFort Wayne, IN · CCN 15002173$3,520About average$2,803$41,864
Saint Joseph Regional Medical CenterMishawaka, IN · CCN 15001243$3,520About average$2,802$18,136
Franciscan Health Crown PointCrown Point, IN · CCN 15012614$3,585About average$2,856$16,613
Franciscan Health MunsterMunster, IN · CCN 15016512$3,585About average$2,856$25,170
St Mary Medical Center IncHobart, IN · CCN 15003421$3,585About average$2,853$20,806
Community HospitalMunster, IN · CCN 15012550$3,585About average$2,853$21,347
Reid HealthRichmond, IN · CCN 15004813$3,639About average$2,899$22,545

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.