Biopsy or removal of deep lymph nodes of underarm
Medicare pricing data for 7,102 providers across 52 states
This procedure has a 5.8x markup — hospitals charge $1,808 but Medicare allows only $313.79. Uninsured patients may face bills 5.8 times higher than what insurance negotiates. Prices vary significantly by location — from $230 in South Dakota to $471 in Alaska. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Biopsy or removal of deep lymph nodes of underarm (HCPCS code 38525) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $313.79, but hospitals typically charge $1,808 — a 5.8x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $313.79, your out-of-pocket cost would be approximately $62.76. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 5.8x more than what Medicare allows for this procedure. Medicare actually pays $250.15 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $471 | $6,069 | 24 | 152 | +50.1% |
| Arkansas | $445 | $1,430 | 72 | 622 | +41.7% |
| Colorado | $398 | $2,779 | 118 | 914 | +26.8% |
| Indiana | $387 | $2,220 | 171 | 1,300 | +23.3% |
| New Jersey | $371 | $2,391 | 167 | 1,307 | +18.3% |
| California | $364 | $2,157 | 622 | 4,814 | +15.9% |
| Nebraska | $363 | $1,551 | 59 | 375 | +15.7% |
| Oregon | $344 | $1,560 | 108 | 744 | +9.7% |
| Maryland | $342 | $1,395 | 116 | 1,428 | +8.8% |
| Kansas | $323 | $1,380 | 95 | 674 | +3.1% |
| Tennessee | $322 | $1,472 | 178 | 1,393 | +2.5% |
| Alabama | $320 | $1,208 | 136 | 689 | +2.0% |
| Virginia | $317 | $1,306 | 172 | 1,941 | +1.0% |
| Wyoming | $316 | $2,309 | 17 | 63 | +0.7% |
| Florida | $315 | $1,642 | 512 | 4,028 | +0.5% |
| North Carolina | $315 | $1,587 | 239 | 1,816 | +0.4% |
| Pennsylvania | $314 | $1,451 | 280 | 2,272 | +0.1% |
| Washington | $313 | $1,389 | 147 | 1,289 | -0.1% |
| Iowa | $312 | $1,416 | 91 | 710 | -0.5% |
| New York | $311 | $2,832 | 355 | 2,769 | -1.0% |
| Illinois | $305 | $2,151 | 275 | 2,115 | -2.7% |
| Texas | $303 | $2,185 | 500 | 3,656 | -3.5% |
| Michigan | $298 | $1,418 | 218 | 1,148 | -5.0% |
| Kentucky | $297 | $1,289 | 117 | 616 | -5.2% |
| Arizona | $297 | $1,608 | 125 | 1,311 | -5.4% |
| Georgia | $295 | $1,740 | 207 | 1,455 | -6.0% |
| Louisiana | $293 | $1,407 | 116 | 725 | -6.6% |
| New Mexico | $291 | $1,620 | 37 | 181 | -7.1% |
| Delaware | $291 | $1,064 | 25 | 191 | -7.2% |
| New Hampshire | $291 | $2,199 | 43 | 326 | -7.3% |
| Idaho | $285 | $1,229 | 40 | 298 | -9.3% |
| Montana | $283 | $1,137 | 41 | 255 | -9.7% |
| Missouri | $279 | $1,757 | 133 | 1,243 | -11.2% |
| Minnesota | $278 | $1,970 | 137 | 712 | -11.5% |
| Wisconsin | $277 | $3,845 | 169 | 908 | -11.8% |
| District of Columbia | $276 | $1,424 | 20 | 269 | -12.1% |
| Hawaii | $275 | $1,335 | 26 | 129 | -12.2% |
| Connecticut | $275 | $1,758 | 85 | 501 | -12.4% |
| Utah | $273 | $1,034 | 62 | 374 | -13.1% |
| South Carolina | $273 | $1,451 | 120 | 976 | -13.1% |
| Mississippi | $271 | $1,216 | 91 | 574 | -13.6% |
| Vermont | $269 | $2,048 | 14 | 136 | -14.4% |
| Massachusetts | $265 | $1,632 | 151 | 1,261 | -15.5% |
| Ohio | $264 | $1,295 | 319 | 1,852 | -16.0% |
| North Dakota | $261 | $1,264 | 34 | 204 | -16.8% |
| West Virginia | $256 | $1,415 | 51 | 213 | -18.4% |
| Nevada | $255 | $1,306 | 37 | 326 | -18.6% |
| Maine | $251 | $1,060 | 38 | 217 | -20.1% |
| Rhode Island | $247 | $1,213 | 21 | 124 | -21.3% |
| Oklahoma | $243 | $1,101 | 83 | 660 | -22.5% |
| Puerto Rico | $230 | $476 | 11 | 22 | -26.8% |
| South Dakota | $230 | $1,158 | 31 | 237 | -26.8% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber