How Much Does Partial Mastectomy Cost?
Also known as: Partial mastectomy (CPT 19301)
A partial mastectomy (lumpectomy) for treatment of breast cancer, removing the tumor with a margin of normal tissue.
The total estimated cost of Partial Mastectomy (CPT 19301) is $1,594 to $2,591, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $633.
Total Estimated Cost of Care
This estimate includes hospital facility fees, anesthesia, and supplies .
Patient Guide: Partial Mastectomy
What you need to know before your appointment
What to Expect
Under general anesthesia, the surgeon removes the cancerous area with a surrounding margin of healthy tissue. Sentinel lymph node biopsy may be performed at the same time.
How Long Does It Take?
1-2 hours
Common Reasons Doctors Order This
Breast cancer treatment (breast-conserving surgery), ductal carcinoma in situ (DCIS)
How to Prepare
Fast before surgery. A wire or seed may be placed in the breast before surgery to guide the surgeon. Radiation therapy usually follows. Arrange help at home.
Procedures Commonly Done Together
These procedures are frequently performed alongside Partial mastectomy
How to Reduce Your Cost for Partial mastectomy
Practical tips that can save you hundreds or thousands of dollars
- 1 Ask about cash-pay discounts
Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.
- 2 Compare facility vs. office setting costs
Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.
- 3 Shop around — costs vary significantly
Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.
How is the Price Calculated?
Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.
Payment = Total RVU (18.94) x CF ($33.40) = $633
Related Procedures
Similar procedures in the same category or body system
People Also Ask
Common questions people search for about this procedure
Is a lumpectomy covered by insurance?
How long do you wait for a lumpectomy?
How much does 6 weeks of radiation cost?
How much is a lumpectomy without insurance?
Frequently Asked Questions
How much does Partial mastectomy cost?
The Medicare facility rate for Partial mastectomy is $633. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).
How much does Partial mastectomy cost without insurance?
Without insurance, the cost of Partial mastectomy can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.
Does insurance cover Partial mastectomy?
Most commercial health insurance plans and Medicare cover Partial mastectomy when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.
Why does the cost vary so much by location?
Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.