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See a sample rate comparisonCPT 19301 Fee Schedule
Medicare rates as of October 2026
CPT 19301 is classified under Surgery, in the Surgical Procedures on the Integumentary System subgroup.
Removal Of Part Of A Breast, Surgery To Remove A Single Lump Or A Portion Of The Breast Tissue (Partial Mastectomy). Nearby Lymph Nodes Also May Be Removed.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $632.61 national non-facility rate (2026) · View Medicare rates for 19301 |
| Medicaid Fee Schedule | $492.645 median of the 8 states in the free preview · View Medicaid rates for 19301 |
National average reimbursement for CPT 19301 by major payers:
$801.77
BCBS / Anthem
$809.81
UnitedHealthcare
$866.03
Aetna
$1,037.70
Cigna
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CPT 19301
5 of 25 sample ratesHigher to lower in this preview
East Mequon Surgery Center LLC
$7,810.00Published rateRyan Jahn
University Physicians Incorporated
$2,238.18Published ratePortercare Adventist Health System, <Unavail>
Portercare Adventist Health System
$1,373.54Published rateJun Elegino
$912.40Published rateMichael Mccann
North Springs Surgical Associates PC
$253.77Published rate
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See a sample payer proposalCPT 19301 vs. Other Surgical Procedures on the Integumentary System Codes
The table lists codes related to 19301. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 19301-CPT | Moderate | Removal Of Part Of A Breast, Surgery To Remove A Single Lump Or A Portion Of The Breast Tissue (Partial Mastectomy). Nearby Lymph Nodes Also May Be Removed. |
| 19302-CPT | High | Removal Of Part Of A Breast, Surgery To Remove A Single Lump Or A Portion Of The Breast Tissue (Partial Mastectomy). Nearby Lymph Nodes Also May Be Removed. |
| 19303-CPT | High | Mastectomy (Breast Removal), Surgery To Remove A Breast (Mastectomy). A Radical Mastectomy Additionally Removes Surrounding Muscle Tissue And Nearby Lymph Nodes. |
| 19305-CPT | High | Mastectomy (Breast Removal), Surgery To Remove A Breast (Mastectomy). A Radical Mastectomy Additionally Removes Surrounding Muscle Tissue And Nearby Lymph Nodes. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 19301. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19301 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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