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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 North Carolina

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
North Carolina
Specific hospitals up to 10
Average payment across these 34 hospitals
$3,383National $3,688 · North Carolina $3,383
Median hospital
$3,380
Lowest to highest
$2,844–$3,557
Medicare procedures
1,510

34 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
Johnston HealthSmithfield, NC · CCN 34009014$2,84423% below the national average$2,147$22,524
Caromont Regional Medical CenterGastonia, NC · CCN 34003232$3,11616% below the national average$2,430$17,868
Pardee Hospital Henderson CountyHendersonville, NC · CCN 34001757$3,27111% below the national average$2,596$18,067
Atrium Health UnionMonroe, NC · CCN 34013039$3,28511% below the national average$2,589$26,642
Novant Health Presbyterian Medical CenterCharlotte, NC · CCN 34005346$3,30610% below the national average$2,610$17,100
Ecu Health Medical CenterGreenville, NC · CCN 34004043$3,31710% below the national average$2,643$24,066
Haywood Regional Medical CenterClyde, NC · CCN 34018412$3,31710% below the national average$2,643$25,816
Memorial Mission Hospital And Asheville Surgery CeAsheville, NC · CCN 34000269$3,31710% below the national average$2,643$28,079
Novant Health Brunswick Medical CenterSupply, NC · CCN 34015813$3,31710% below the national average$2,643$15,695
AdventHealth HendersonvilleHendersonville, NC · CCN 34002319$3,31710% below the national average$2,639$22,987
Columbus Regional Healthcare SystemWhiteville, NC · CCN 34006816$3,31710% below the national average$2,638$19,127
Moses H. Cone The Memorial HospitalGreensboro, NC · CCN 340091110$3,322About average$2,625$14,744
Carolinas Medical Center/Behavioral HealthCharlotte, NC · CCN 34011391$3,346About average$2,653$33,991
Cape Fear Valley Medical CenterFayetteville, NC · CCN 34002817$3,371About average$2,686$12,935
UNC Health NashRocky Mount, NC · CCN 34014714$3,371About average$2,686$17,853
Catawba Valley Medical CenterHickory, NC · CCN 34014320$3,371About average$2,686$17,623
FirstHealth Moore Regional HospitalPinehurst, NC · CCN 34011534$3,379About average$2,692$18,397
Atrium Health PinevilleCharlotte, NC · CCN 34009863$3,382About average$2,686$34,132
Atrium Health ClevelandShelby, NC · CCN 34002114$3,389About average$2,700$33,460
Novant Health Medical Park HospitalWinston-Salem, NC · CCN 34014869$3,394About average$2,688$12,237
Novant Health Ballantyne Medical CenterCharlotte, NC · CCN 34019511$3,407About average$2,714$17,689
Rex HospitalRaleigh, NC · CCN 340114149$3,413About average$2,716$11,836
Duke University HospitalDurham, NC · CCN 340030153$3,420About average$2,721$21,368
Atrium Health LincolnLincolnton, NC · CCN 34014515$3,425About average$2,729$26,469
Novant Health Matthews Medical CenterMatthews, NC · CCN 34017126$3,425About average$2,729$20,551
Duke Health Raleigh HospitalRaleigh, NC · CCN 34007317$3,432About average$2,734$21,147
WakeMed, Cary HospitalCary, NC · CCN 34017323$3,432About average$2,734$30,065
UNC HospitalsChapel Hill, NC · CCN 340061133$3,460About average$2,752$17,158
North Carolina Baptist HospitalWinston-Salem, NC · CCN 34004739$3,475About average$2,763$37,918
Novant Health New Hanover Regional Medical CenterWilmington, NC · CCN 34014185$3,526About average$2,810$16,811
Carolina East Medical CenterNew Bern, NC · CCN 34013127$3,553About average$2,830$16,266
Onslow Memorial HospitalJacksonville, NC · CCN 34004211$3,553About average$2,830$21,912
Sentara Albemarle Medical CenterElizabeth City, NC · CCN 34010911$3,553About average$2,830$27,134
Carteret General HospitalMorehead City, NC · CCN 34014218$3,557About average$2,834$12,015

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.