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 Pennsylvania

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.

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Pennsylvania

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Average payment across these 66 hospitals: $3,501National $3,688 · Pennsylvania $3,508
Median hospital: $3,492
Lowest to highest: $1,819–$4,017
Medicare procedures: 2,336

66 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
Geisinger-Lewistown HospitalLewistown, PA · CCN 390048	20	$1,819	51% below the national average	$1,449	$25,532
UPMC MemorialYork, PA · CCN 390101	22	$1,838	50% below the national average	$1,454	$18,415
Gettysburg HospitalGettysburg, PA · CCN 390065	23	$2,678	27% below the national average	$2,134	$12,786
Magee Womens Hospital Of UPMC Health SystemPittsburgh, PA · CCN 390114	82	$2,923	21% below the national average	$2,321	$26,938
Geisinger Wyoming Valley Medical CenterWilkes Barre, PA · CCN 390270	42	$3,048	17% below the national average	$2,415	$59,486
St Clair HospitalPittsburgh, PA · CCN 390228	16	$3,235	12% below the national average	$2,543	$15,703
Geisinger-Community Medical CenterScranton, PA · CCN 390001	27	$3,304	10% below the national average	$2,612	$54,484
Geisinger Medical CenterDanville, PA · CCN 390006	63	$3,318	10% below the national average	$2,626	$62,824
Ahn Wexford HospitalWexford, PA · CCN 390334	25	$3,405	About average	$2,713	$22,964
Allegheny General HospitalPittsburgh, PA · CCN 390050	12	$3,405	About average	$2,713	$28,644
Excela Health Westmoreland Regional HospitalGreensburg, PA · CCN 390145	16	$3,405	About average	$2,713	$15,601
Forbes HospitalMonroeville, PA · CCN 390267	17	$3,405	About average	$2,713	$24,012
Geisinger-Bloomsburg HospitalBloomsburg, PA · CCN 390003	11	$3,405	About average	$2,713	$44,514
Jefferson HospitalJefferson Hills, PA · CCN 390265	25	$3,405	About average	$2,713	$21,306
Lehigh Valley Hospital - Dickson CityDickson City, PA · CCN 390338	26	$3,405	About average	$2,713	$27,152
Penn Highlands Mon ValleyMonongahela, PA · CCN 390147	11	$3,405	About average	$2,713	$17,215
Regional Hospital Of ScrantonScranton, PA · CCN 390237	21	$3,405	About average	$2,713	$41,664
UPMC JamesonNew Castle, PA · CCN 390016	12	$3,405	About average	$2,713	$10,144
UPMC PassavantPittsburgh, PA · CCN 390107	27	$3,405	About average	$2,713	$30,840
UPMC Presbyterian ShadysidePittsburgh, PA · CCN 390164	57	$3,405	About average	$2,713	$56,627
UPMC WilliamsportWilliamsport, PA · CCN 390045	30	$3,405	About average	$2,713	$29,455
Wellspan Evangelical Community HospitalLewisburg, PA · CCN 390013	13	$3,405	About average	$2,713	$38,982
West Penn HospitalPittsburgh, PA · CCN 390090	27	$3,405	About average	$2,713	$26,299
Wilkes-Barre General HospitalWilkes-Barre, PA · CCN 390137	17	$3,405	About average	$2,713	$46,897
Penn State Health Hampden Medical CenterEnola, PA · CCN 390336	20	$3,416	About average	$2,721	$37,120
UPMC Pinnacle HospitalsHarrisburg, PA · CCN 390067	57	$3,416	About average	$2,718	$22,680
UPMC LititzLititz, PA · CCN 390068	17	$3,426	About average	$2,730	$20,956
Penn Highlands DuboisDubois, PA · CCN 390086	25	$3,439	About average	$2,716	$12,480
Hospital Of University Of PennsylvaniaPhiladelphia, PA · CCN 390111	166	$3,465	About average	$2,761	$58,046
St Luke's Hospital - Anderson CampusEaston, PA · CCN 390326	40	$3,474	About average	$2,768	$53,161
Penn State Health St. JosephReading, PA · CCN 390096	21	$3,476	About average	$2,769	$47,855
Wellspan Ephrata Community HospitalEphrata, PA · CCN 390225	32	$3,476	About average	$2,769	$22,997
Reading HospitalWest Reading, PA · CCN 390044	24	$3,483	About average	$2,775	$23,580
Robert Packer HospitalSayre, PA · CCN 390079	20	$3,501	About average	$2,790	$22,774
Wellspan York HospitalYork, PA · CCN 390046	36	$3,508	About average	$2,777	$17,446
Thomas Jefferson University HospitalPhiladelphia, PA · CCN 390174	64	$3,533	About average	$2,815	$31,173
Lancaster General HospitalLancaster, PA · CCN 390100	96	$3,546	About average	$2,825	$24,385
Milton S Hershey Medical CenterHershey, PA · CCN 390256 · +$1,494 outlier payments per case	60	$3,558	About average	$2,833	$41,724
Lehigh Valley Hospital - PoconoEast Stroudsburg, PA · CCN 390201	20	$3,570	About average	$2,814	$27,226
Holy Redeemer Hospital And Medical CenterMeadowbrook, PA · CCN 390097	32	$3,576	About average	$2,849	$13,633
Jefferson Einstein Montgomery HospitalEast Norriton, PA · CCN 390329	46	$3,576	About average	$2,846	$13,002
Phoenixville HospitalPhoenixville, PA · CCN 390127	29	$3,579	About average	$2,831	$30,818
St Luke's Hospital - Monroe CampusStroudsburg, PA · CCN 390330	17	$3,611	About average	$2,877	$46,628
Wellspan Good Samaritan HospitalLebanon, PA · CCN 390066	43	$3,614	About average	$2,880	$17,752
Conemaugh Memorial Medical CenterJohnstown, PA · CCN 390110	16	$3,646	About average	$2,905	$19,440
Indiana Regional Medical CenterIndiana, PA · CCN 390173	15	$3,652	About average	$2,910	$24,033
Crozer Chester Medical CenterUpland, PA · CCN 390180	31	$3,663	About average	$2,905	$43,334
Doylestown HospitalDoylestown, PA · CCN 390203	11	$3,677	About average	$2,930	$27,011
Main Line Hospital LankenauWynnewood, PA · CCN 390195	45	$3,677	About average	$2,930	$20,496
Paoli HospitalPaoli, PA · CCN 390153	44	$3,677	About average	$2,930	$18,795

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.