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 Washington

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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Washington

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Year of care

Average payment across these 29 hospitals: $3,892National $3,688 · Washington $3,892
Median hospital: $3,893
Lowest to highest: $3,696–$4,097
Medicare procedures: 1,036

29 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
Hospital	Cases	Average payment	vs national average	Medicare paid	Billed charge
Virginia Mason Medical CenterSeattle, WA · CCN 500005	50	$3,696	About average	$2,920	$24,850
Providence Sacred Heart Medical Center & Childrens HospitalSpokane, WA · CCN 500054	80	$3,798	About average	$3,020	$20,774
Overlake Hospital Medical Center & ClinicsBellevue, WA · CCN 500051	35	$3,804	About average	$3,013	$30,958
Deaconess Medical CenterSpokane, WA · CCN 500044	22	$3,826	About average	$3,048	$21,032
Kadlec Regional Medical CenterRichland, WA · CCN 500058	26	$3,826	About average	$3,048	$20,360
Multicare Valley HospitalSpokane Valley, WA · CCN 500119	12	$3,826	About average	$3,048	$17,365
Providence Holy Family HospitalSpokane, WA · CCN 500077	25	$3,826	About average	$3,048	$26,467
University Of Washington Medical CenterSeattle, WA · CCN 500008	150	$3,826	About average	$3,047	$20,740
Island HospitalAnacortes, WA · CCN 500007	14	$3,854	About average	$3,071	$18,681
Providence St Peter HospitalOlympia, WA · CCN 500024	43	$3,854	About average	$3,071	$21,262
Skagit Valley HospitalMount Vernon, WA · CCN 500003	21	$3,854	About average	$3,071	$21,820
Legacy Salmon Creek Medical CenterVancouver, WA · CCN 500150	26	$3,877	About average	$3,064	$18,160
PeaceHealth St Joseph Medical CenterBellingham, WA · CCN 500030	15	$3,880	About average	$3,047	$30,593
Evergreenhealth Medical CenterKirkland, WA · CCN 500124	42	$3,893	About average	$3,102	$13,608
Providence Regional Medical Center EverettEverett, WA · CCN 500014	41	$3,893	About average	$3,102	$19,764
St Francis Community HospitalFederal Way, WA · CCN 500141	12	$3,893	About average	$3,102	$71,215
Swedish IssaquahIssaquah, WA · CCN 500152	25	$3,893	About average	$3,102	$23,861
Valley Medical CenterRenton, WA · CCN 500088	22	$3,893	About average	$3,102	$22,031
PeaceHealth Southwest Medical CenteVancouver, WA · CCN 500050	33	$3,903	About average	$3,090	$28,840
St Joseph Medical CenterTacoma, WA · CCN 500108	33	$3,927	About average	$3,129	$56,929
Capital Medical CenterOlympia, WA · CCN 500139	20	$3,927	About average	$3,129	$34,910
Tacoma General Allenmore HospitalTacoma, WA · CCN 500129	73	$3,927	About average	$3,129	$31,932
St Anthony HospitalGig Harbor, WA · CCN 500151	23	$3,927	About average	$3,127	$48,537
Confluence Health HospitalWenatchee, WA · CCN 500016	31	$4,021	About average	$3,183	$22,492
St Michael Medical CenterSilverdale, WA · CCN 500039	51	$4,047	About average	$3,211	$43,758
Swedish Medical CenterSeattle, WA · CCN 500027	54	$4,084	11% above the national average	$3,254	$31,745
Olympic Medical CenterPort Angeles, WA · CCN 500072	16	$4,097	11% above the national average	$3,264	$11,598
Providence St Mary Medical CenterWalla Walla, WA · CCN 500002	15	$4,097	11% above the national average	$3,264	$33,312
Yakima Valley MemorialYakima, WA · CCN 500036	26	$4,097	11% above the national average	$3,264	$14,971

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.