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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 Kentucky

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
Kentucky
Specific hospitals up to 10
Average payment across these 17 hospitals
$3,266National $3,688 · Kentucky $3,266
Median hospital
$3,281
Lowest to highest
$3,078–$3,527
Medicare procedures
677

17 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
St Elizabeth EdgewoodEdgewood, KY · CCN 18003564$3,07817% below the national average$2,408$17,778
University Of Kentucky HospitalLexington, KY · CCN 18006744$3,14015% below the national average$2,468$29,130
Baptist Health CorbinCorbin, KY · CCN 18008017$3,19813% below the national average$2,548$20,011
University Of Louisville HospitalLouisville, KY · CCN 18014147$3,22313% below the national average$2,559$25,507
King's Daughters' Medical CenterAshland, KY · CCN 18000939$3,24712% below the national average$2,577$16,824
Norton Hospitals, IncLouisville, KY · CCN 180088119$3,25112% below the national average$2,585$15,381
Baptist Health LouisvilleLouisville, KY · CCN 180130111$3,27311% below the national average$2,604$30,476
Pikeville Medical CenterPikeville, KY · CCN 18004415$3,27811% below the national average$2,574$24,599
Ephraim McDowell Regional Medical CenterDanville, KY · CCN 18004811$3,28111% below the national average$2,614$12,763
Baptist Health HardinElizabethtown, KY · CCN 18001248$3,28411% below the national average$2,617$26,219
The Medical Center (Bowling Green)Bowling Green, KY · CCN 18001316$3,29311% below the national average$2,621$17,129
Saint Joseph EastLexington, KY · CCN 18014320$3,30111% below the national average$2,630$13,146
Baptist Health LexingtonLexington, KY · CCN 18010334$3,30111% below the national average$2,629$30,241
Baptist Health PaducahPaducah, KY · CCN 18010433$3,405About average$2,691$28,161
Mercy Health - Lourdes HospitalPaducah, KY · CCN 18010225$3,488About average$2,766$22,636
Baptist Health Deaconess MadisonvilleMadisonville, KY · CCN 18009312$3,527About average$2,810$33,944
Owensboro Health Regional HospitalOwensboro, KY · CCN 18003822$3,527About average$2,810$21,612

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.