Breast Biopsy, Local Excision and Other Breast Procedures without Complications/mcc — what U.S. hospitals charge
MS-DRG 585 · Inpatient stay · 2 U.S. hospitals publish a price
Cheapest quarter
under $157,516
Typical charge
$158,593
Dearest quarter
over $159,670
Actually paid
$22,017
The middle U.S. hospital bills $158,593 for Breast Biopsy, Local Excision and Other Breast Procedures without Complications/mcc. The dearest hospitals charge about 1.0x what the cheapest do for the same coded work. Medicare actually paid about $22,017 per case.
These are charges, not quotes. What you pay depends on your insurance and your own case. The figures matter because the charge is where an uninsured or out-of-network bill starts.
Where Breast Biopsy, Local Excision and Other Breast Procedures without Complications/mcc is charged least
Hospitals that performed it at least eleven times, so a single case cannot set the figure.
| Hospital | Charged | Actually paid |
|---|---|---|
|
St Charles Surgical Hospital
New Orleans, LA |
$156,438 | $12,759 |
|
University Of Kansas Hospital
Kansas City, KS |
$160,748 | $31,275 |
Where it is charged most
Hospitals that performed it at least eleven times, so a single case cannot set the figure.
| Hospital | Charged | Actually paid |
|---|---|---|
|
University Of Kansas Hospital
Kansas City, KS |
$160,748 | $31,275 |
|
St Charles Surgical Hospital
New Orleans, LA |
$156,438 | $12,759 |
Questions people ask
What do U.S. hospitals charge for Breast Biopsy, Local Excision and Other Breast Procedures without Complications/mcc?
Across 2 U.S. hospitals, the middle charge for Breast Biopsy, Local Excision and Other Breast Procedures without Complications/mcc is $158,593. Half of hospitals charge less than that and half charge more. The cheapest quarter charge under $157,516 and the dearest quarter over $159,670.
Why do hospitals charge such different amounts for the same procedure?
Because a hospital charge is a list price it sets itself, not a regulated rate. For Breast Biopsy, Local Excision and Other Breast Procedures without Complications/mcc, the hospitals in the dearest tenth charge about 1.0x what the cheapest tenth charge for the same coded work. Insurers negotiate their own rates from those lists, which is why the charge and what is actually paid can be very far apart.
Is that what I would actually pay?
No. $22,017 is roughly what Medicare actually paid per case, against an average charge of $157,793. If you have insurance, your plan pays a negotiated rate and you pay your deductible and coinsurance. If you are uninsured or out of network, the hospital's charge is where your bill starts — which is why the gap matters. Ask for a written good-faith estimate before treatment.
What this code covers
CMS records this work as MS-DRG 585: “BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC”. A DRG covers a whole inpatient stay rather than a single item, so the charge includes the room, the procedure and the care around it. Codes that mention complications carry a different, usually higher price.