Outpatient / APC 5093
APC 5093 · 108 hospitals · 4,771 services
Level 3 Breast/Lymphatic Surgery and Related Procedures
Hospital outpatient departments billed Medicare for 4,771 services in APC 5093 in 2024. They charged an average of $71,544; Medicare allowed $9,050 — a ratio of 7.9 to 1 — and paid $7,421 of it, the patient's coinsurance making up most of the rest. Average charges ranged from $18,596 to $257,676 across hospitals.
- 1Average charge $71,544
- 2Medicare allowed $9,050
- 3Reporting hospitals 108
- 4Services 4,771
By state
The average charge for this service was highest in Arizona ($105,959) and lowest in Rhode Island ($27,006). The allowed amount is set by Medicare's outpatient fee schedule, adjusted for local wages, so it varies much less.
| State | Services | Avg charge | Avg allowed |
|---|---|---|---|
| Arizona | 157 | $105,959 | $9,122 |
| Colorado | 103 | $103,339 | $8,936 |
| California | 486 | $95,587 | $11,915 |
| Alabama | 66 | $94,378 | $7,373 |
| Kentucky | 62 | $93,351 | $8,212 |
| Florida | 555 | $90,392 | $8,454 |
| Idaho | 13 | $88,432 | $8,564 |
| Mississippi | 21 | $86,339 | $6,634 |
| Nevada | 23 | $84,966 | $9,723 |
| Texas | 332 | $78,055 | $8,464 |
| New Mexico | 34 | $77,402 | $8,318 |
| Virginia | 147 | $76,671 | $8,269 |
| North Carolina | 162 | $75,639 | $8,340 |
| Iowa | 31 | $73,057 | $8,187 |
| Indiana | 52 | $72,470 | $8,564 |
| South Carolina | 95 | $70,145 | $8,059 |
| South Dakota | 56 | $67,843 | $8,824 |
| Kansas | 45 | $67,243 | $8,259 |
| Georgia | 199 | $67,215 | $8,282 |
| District of Columbia | 27 | $65,679 | $9,342 |
| Pennsylvania | 169 | $65,642 | $8,483 |
| Louisiana | 68 | $62,457 | $7,959 |
| New York | 333 | $62,326 | $10,456 |
| Washington | 82 | $62,199 | $9,591 |
| New Hampshire | 34 | $58,255 | $8,623 |
| Arkansas | 25 | $58,156 | $7,790 |
| New Jersey | 136 | $58,138 | $10,117 |
| Ohio | 159 | $57,488 | $7,976 |
| Illinois | 188 | $57,476 | $8,893 |
| Montana | 13 | $57,245 | $8,931 |
| Michigan | 115 | $55,249 | $8,130 |
| Maine | 18 | $54,780 | $8,631 |
| North Dakota | 11 | $54,263 | $9,062 |
| Oklahoma | 51 | $48,283 | $8,030 |
| Tennessee | 115 | $48,269 | $7,754 |
| Missouri | 113 | $47,418 | $7,983 |
| Nebraska | 40 | $46,903 | $8,322 |
| Connecticut | 35 | $46,217 | $10,063 |
| Wisconsin | 51 | $45,054 | $8,703 |
| Oregon | 30 | $44,908 | $9,947 |
| Utah | 42 | $43,066 | $8,247 |
| Massachusetts | 139 | $36,635 | $9,998 |
| Minnesota | 65 | $34,463 | $9,155 |
| Delaware | 35 | $31,984 | $9,454 |
| Rhode Island | 11 | $27,006 | $9,560 |
Highest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Cjw Medical Center Richmond, VA | $257,676 | $8,116 |
| Brookwood Baptist Medical Center Vestavia, AL | $190,526 | $6,824 |
| St David's Medical Center Austin, TX | $184,515 | $8,296 |
| Cedars-Sinai Medical Center Los Angeles, CA | $177,334 | $11,575 |
| Memorial Mission Hospital and Asheville Surgery Ce Asheville, NC | $169,062 | $8,202 |
| Honorhealth Scottsdale Osborn Medical Center Scottsdale, AZ | $164,560 | $9,187 |
| Honorhealth Scottsdale Shea Medical Center Scottsdale, AZ | $157,251 | $9,187 |
| Baptist Health Hardin Elizabethtown, KY | $152,603 | $8,121 |
| Methodist Hospital San Antonio, TX | $151,076 | $8,179 |
| Chandler Regional Medical Center Chandler, AZ | $142,798 | $9,187 |
Lowest average charges
| Hospital | Charge | Allowed |
|---|---|---|
| Beth Israel Deaconess Medical Center Boston, MA | $18,596 | $9,420 |
| Christianacare Newark, DE | $18,912 | $9,452 |
| Bethesda North Cincinnati, OH | $21,010 | $8,197 |
| North Central Surgical Center Llp Dallas, TX | $22,638 | $8,481 |
| Cox Medical Centers Springfield, MO | $24,395 | $7,926 |
| Baptist Memorial Hospital Memphis, TN | $27,323 | $7,254 |
| Memorial Hospital for Cancer and Allied Diseases New York, NY | $28,555 | $10,716 |
| University of Texas M D Anderson Cancer Center Houston, TX | $31,161 | $8,738 |
| Brigham and Women's Faulkner Hospital Boston, MA | $31,569 | $10,115 |
| Mount Sinai Hospital New York, NY | $35,022 | $10,716 |
An APC groups services of similar cost, so a hospital's average mixes the specific procedures it does most. Charges are list prices; the allowed amount is the fee-schedule total that Medicare and the patient together pay the hospital.
Source: CMS Medicare Outpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024. Checked 2026-10-24. Methodology.