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Outpatient procedure · APC 5094 · Surgery or procedure

Level 4 Breast/Lymphatic Surgery and Related Procedures

In 2024, Medicare and patients paid an average of $17,182 per procedure at 47 hospitals. Half of hospitals averaged between $15,800 and $18,259.

Also known as: Lumpectomy, mastectomy, breast surgery

National figures, 2024

Average payment per case
$17,182
Typical range (middle half of hospitals)
$15,800–$18,259
Medicare’s share
$15,54990% of the payment
Average billed charge
$100,681
Hospitals reporting
47789 procedures

Hospitals in California

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
California
Specific hospitals up to 10
Average payment across these 3 hospitals
$21,610National $17,182 · California $21,610
Median hospital
$21,610
Lowest to highest
$21,610–$21,610
Medicare procedures
52

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

Medicare payments per case for Level 4 Breast/Lymphatic Surgery and Related Procedures by hospital, 2024
HospitalCasesAverage paymentvs national averageMedicare paidBilled charge
Cedars-Sinai Medical CenterLos Angeles, CA · CCN 05062515$21,61026% above the national average$19,978$264,517
Scripps Memorial Hospital La JollaLa Jolla, CA · CCN 05032422$21,61026% above the national average$19,978$198,575
Sharp Memorial HospitalSan Diego, CA · CCN 05010015$21,61026% above the national average$19,978$112,893

National trend

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

  • Average payment
  • Average billed charge
2020: 658 procedures at 37 hospitals · 2021: 833 procedures at 48 hospitals · 2022: 731 procedures at 39 hospitals · 2023: 760 procedures at 43 hospitals · 2024: 789 procedures at 47 hospitals
View data as a table
National average payment and billed charge for Level 4 Breast/Lymphatic Surgery and Related Procedures
Year of careAverage paymentAverage billed charge
2020$14K$95K
2021$15K$95K
2022$16K$92K
2023$17K$101K
2024$17K$101K

By state, 2024

Case-weighted average payment across each state’s reporting hospitals, lowest first.

Show all 24 states
Average payment by state for Level 4 Breast/Lymphatic Surgery and Related Procedures, 2024
StateHospitalsCasesAverage paymentTypical range
Missouri111$13,594$13,594–$13,594
Kentucky113$14,052$14,052–$14,052
Indiana112$14,054$14,054–$14,054
Tennessee112$14,684$14,684–$14,684
Louisiana115$14,872$14,872–$14,872
Arkansas111$15,076$15,076–$15,076
Oklahoma111$15,153$15,153–$15,153
Ohio231$15,288$15,207–$15,592
Kansas123$15,416$15,416–$15,416
Virginia114$15,429$15,429–$15,429
Georgia120$15,586$15,586–$15,586
Texas5111$15,873$15,826–$15,826
Florida7101$15,930$15,930–$15,930
Michigan111$16,268$16,268–$16,268
South Dakota114$16,487$16,487–$16,487
Arizona224$16,500$16,251–$16,848
Illinois245$16,689$16,545–$16,916
Minnesota339$17,377$16,809–$17,460
Delaware112$17,641$17,641–$17,641
District of Columbia112$17,989$17,989–$17,989
Massachusetts129$18,881$18,881–$18,881
New Jersey339$19,036$18,521–$19,210
New York5127$19,850$19,634–$20,003
California352$21,610$21,610–$21,610

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.