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Outpatient procedure · APC 5092 · Surgery or procedure

Level 2 Breast/Lymphatic Surgery and Related Procedures

In 2024, Medicare and patients paid an average of $6,262 per procedure at 1,216 hospitals. Half of hospitals averaged between $5,674 and $6,551.

Also known as: Lumpectomy, mastectomy, breast surgery

National figures, 2024

Average payment per case
$6,262
Typical range (middle half of hospitals)
$5,674–$6,551
Medicare’s share
$4,98280% of the payment
Average billed charge
$46,583
Hospitals reporting
1,21645,070 procedures

Hospitals in Rhode Island

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
Rhode Island
Specific hospitals up to 10
Average payment across these 3 hospitals
$6,557National $6,262 · Rhode Island $6,557
Median hospital
$6,618
Lowest to highest
$6,489–$6,618
Medicare procedures
87

3 hospitals reported at least 11 Medicare procedures for this in 2024. Download as CSV

Medicare payments per case for Level 2 Breast/Lymphatic Surgery and Related Procedures by hospital, 2024
HospitalCasesAverage paymentvs national averageMedicare paidBilled charge
Rhode Island HospitalProvidence, RI · CCN 41000741$6,489About average$5,144$22,626
Kent County Memorial HospitalWarwick, RI · CCN 41000914$6,618About average$5,273$33,280
Women & Infants Hospital Of Rhode IslandProvidence, RI · CCN 41001032$6,618About average$5,273$23,513

National trend

Average payment and billed charge per procedure, and how many Medicare procedures were reported each year.

  • Average payment
  • Average billed charge
2020: 50,714 procedures at 1,353 hospitals · 2021: 52,831 procedures at 1,346 hospitals · 2022: 50,810 procedures at 1,301 hospitals · 2023: 47,932 procedures at 1,286 hospitals · 2024: 45,070 procedures at 1,216 hospitals
View data as a table
National average payment and billed charge for Level 2 Breast/Lymphatic Surgery and Related Procedures
Year of careAverage paymentAverage billed charge
2020$5,229$36K
2021$5,585$38K
2022$5,645$40K
2023$5,915$43K
2024$6,262$47K

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 2 Breast/Lymphatic Surgery and Related Procedures, 2024
StateHospitalsCasesAverage paymentTypical range
Vermont3118$4,160$3,803–$4,059
Mississippi19520$5,371$5,325–$5,445
Alabama20544$5,412$5,348–$5,461
Louisiana17582$5,439$5,422–$5,511
Tennessee281,074$5,486$5,378–$5,618
West Virginia10281$5,495$5,362–$5,548
Oklahoma15682$5,547$5,466–$5,618
Ohio511,678$5,560$5,511–$5,671
Arkansas14484$5,566$5,493–$5,807
South Carolina281,141$5,596$5,517–$5,626
Missouri28943$5,612$5,483–$5,745
Kentucky22626$5,638$5,558–$5,881
Iowa15567$5,650$5,553–$5,848
Kansas14703$5,682$5,599–$5,837
Georgia381,275$5,760$5,574–$5,977
Florida713,400$5,779$5,907–$5,907
North Carolina321,398$5,780$5,675–$5,861
Virginia371,747$5,784$5,573–$6,004
Texas873,053$5,831$5,659–$5,887
Michigan341,051$5,842$5,687–$5,951
Utah10434$5,863$5,752–$5,842
Nebraska13448$5,886$5,823–$6,018
Indiana30745$5,891$5,813–$5,986
New Mexico8220$5,917$5,625–$5,976
Maine5188$6,012$5,856–$6,127
Wisconsin27803$6,018$5,874–$6,133
Pennsylvania641,972$6,054$5,824–$6,291
Idaho9266$6,081$5,868–$6,285
South Dakota9382$6,105$6,114–$6,548
Illinois511,814$6,165$6,027–$6,254
Montana8302$6,212$6,086–$6,453
Colorado22546$6,225$6,208–$6,208
North Dakota5264$6,231$6,114–$6,469
Minnesota23823$6,347$6,187–$6,501
Arizona261,283$6,367$6,316–$6,359
New Hampshire9317$6,407$6,252–$6,491
Wyoming699$6,463$6,453–$6,548
Delaware4265$6,506$6,525–$6,547
Rhode Island387$6,557$6,554–$6,618
District of Columbia4237$6,582$6,566–$6,672
Washington271,081$6,649$6,543–$6,771
Alaska4108$6,751$6,603–$7,009
New Jersey27995$6,924$6,716–$7,032
Oregon18518$6,943$6,773–$7,099
Nevada9314$6,951$6,984–$6,984
Massachusetts351,462$6,961$6,922–$7,003
New York552,552$7,195$6,914–$7,348
Connecticut15434$7,225$7,099–$7,345
Hawaii6154$7,505$7,368–$7,707
California1014,090$8,292$8,017–$8,390

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.