Partial removal of breast
Medicare pricing data for 6,564 providers across 52 states
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
Partial removal of breast (HCPCS code 19301) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $641.19, but hospitals typically charge $2,503 — a 3.9x 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 $641.19, your out-of-pocket cost would be approximately $128.24. 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 3.9x more than what Medicare allows for this procedure. Medicare actually pays $509.52 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $774 | $6,237 | 31 | 218 | +20.7% |
| New Jersey | $749 | $3,417 | 139 | 2,024 | +16.8% |
| District of Columbia | $742 | $2,047 | 12 | 302 | +15.7% |
| New York | $721 | $3,592 | 352 | 4,205 | +12.4% |
| Maryland | $718 | $2,194 | 107 | 1,948 | +12.0% |
| Colorado | $702 | $3,639 | 104 | 1,212 | +9.5% |
| Connecticut | $687 | $2,540 | 75 | 683 | +7.1% |
| Massachusetts | $685 | $2,384 | 125 | 2,022 | +6.8% |
| Illinois | $679 | $2,684 | 254 | 2,752 | +5.8% |
| Pennsylvania | $672 | $2,002 | 245 | 3,023 | +4.8% |
| Virginia | $670 | $2,132 | 152 | 2,662 | +4.6% |
| Florida | $665 | $2,373 | 475 | 4,764 | +3.7% |
| New Hampshire | $658 | $2,818 | 40 | 495 | +2.6% |
| Hawaii | $655 | $2,157 | 22 | 170 | +2.1% |
| California | $654 | $3,140 | 629 | 6,985 | +2.0% |
| New Mexico | $653 | $3,059 | 28 | 245 | +1.8% |
| Vermont | $652 | $2,637 | 15 | 162 | +1.7% |
| Louisiana | $645 | $2,096 | 90 | 673 | +0.6% |
| Delaware | $643 | $1,762 | 21 | 314 | +0.2% |
| Indiana | $641 | $3,269 | 181 | 1,837 | -0.1% |
| Georgia | $634 | $2,246 | 174 | 1,706 | -1.2% |
| Arkansas | $632 | $1,978 | 55 | 623 | -1.4% |
| Ohio | $631 | $1,863 | 268 | 2,069 | -1.5% |
| Oklahoma | $629 | $1,624 | 47 | 639 | -1.8% |
| Montana | $628 | $1,531 | 29 | 332 | -2.1% |
| Texas | $628 | $2,992 | 403 | 4,041 | -2.1% |
| Kentucky | $621 | $1,865 | 92 | 740 | -3.1% |
| Washington | $620 | $2,104 | 156 | 1,714 | -3.3% |
| Missouri | $610 | $1,768 | 119 | 1,241 | -4.8% |
| North Carolina | $609 | $2,173 | 212 | 2,591 | -5.0% |
| Oregon | $608 | $2,277 | 124 | 1,089 | -5.2% |
| Alabama | $608 | $1,788 | 121 | 811 | -5.2% |
| Puerto Rico | $604 | $747 | 15 | 33 | -5.8% |
| Michigan | $604 | $1,741 | 229 | 1,820 | -5.8% |
| Tennessee | $603 | $2,398 | 153 | 1,634 | -6.0% |
| North Dakota | $600 | $1,984 | 35 | 266 | -6.4% |
| South Carolina | $599 | $1,890 | 107 | 1,423 | -6.6% |
| Wisconsin | $583 | $3,585 | 161 | 1,154 | -9.1% |
| Arizona | $578 | $2,258 | 114 | 1,734 | -9.8% |
| Rhode Island | $563 | $1,875 | 16 | 250 | -12.2% |
| Kansas | $560 | $2,008 | 77 | 748 | -12.6% |
| Minnesota | $560 | $2,642 | 174 | 1,001 | -12.7% |
| Mississippi | $549 | $1,439 | 76 | 516 | -14.3% |
| West Virginia | $536 | $1,513 | 55 | 272 | -16.4% |
| Iowa | $527 | $2,019 | 95 | 862 | -17.7% |
| Nebraska | $522 | $1,941 | 69 | 547 | -18.5% |
| Nevada | $519 | $1,992 | 40 | 357 | -19.1% |
| Utah | $516 | $1,484 | 68 | 555 | -19.5% |
| Maine | $515 | $1,270 | 34 | 362 | -19.7% |
| Wyoming | $509 | $2,687 | 21 | 136 | -20.6% |
| Idaho | $496 | $1,448 | 55 | 488 | -22.7% |
| South Dakota | $422 | $1,381 | 29 | 355 | -34.2% |
⚠️ 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