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See a sample rate comparisonCPT 19303 Fee Schedule
Medicare rates as of October 2026
CPT 19303 is classified under Surgery, in the Surgical Procedures on the Integumentary System subgroup.
Mastectomy (Breast Removal), Surgery To Remove A Breast (Mastectomy). A Radical Mastectomy Additionally Removes Surrounding Muscle Tissue And Nearby Lymph Nodes.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | 50 - Bilateral Procedure LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | $915.85 national non-facility rate (2026) · View Medicare rates for 19303 |
| Medicaid Fee Schedule | $712.78 median of the 8 states in the free preview · View Medicaid rates for 19303 |
National average reimbursement for CPT 19303 by major payers:
$1,232.47
BCBS / Anthem
$1,234.89
UnitedHealthcare
$1,312.32
Aetna
$1,549.32
Cigna
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CPT 19303
5 of 25 sample ratesHigher to lower in this preview
Manuel Rodriguez Montana
University Physicians Incorporated
$4,160.79Published rateAngela Peltz
University Physicians Incorporated
$3,265.37Published rateSpine And Pain Physicians Surgery Center, LLC
Spine And Pain Physicians Surgery Center LLC
$1,927.00Published rateAndrew Federer
Poudre Valley Medical Group LLC
$1,607.56Published ratePodiatry Group Of Annapolis Ambulatory Surgical Center, Podiatry Group Of Annapolis Ambulatory Surgical Center LLC
Podiatry Group Of Annapolis Ambulatory Surgical Center
$753.00Published rate
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See a sample payer proposalCPT 19303 vs. Other Surgical Procedures on the Integumentary System Codes
The table lists codes related to 19303. 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 19303. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19303 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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Frequently Asked Questions
To get an estimate for a medical procedure, you can contact your insurance provider to understand your specific coverage, deductibles, and co-pays. For precise cost estimates based on CPT codes and your specific location, you can also utilize resources like Payerprice. They offer a fee schedule lookup tool where you can search with a CPT code to get an idea of expected costs, helping you budget for potential out-of-pocket expenses.
CPT stands for Current Procedural Terminology. These are a standardized set of medical codes used by healthcare professionals to describe medical, surgical, and diagnostic services provided to patients. They are crucial for accurate medical billing and for communicating services to insurance companies, ensuring consistent tracking and reimbursement across the healthcare system. When looking up prices, CPT codes are essential for identifying the specific service.
Medical costs can vary significantly due to several factors, including the type of facility (e.g., hospital vs. independent clinic), geographic location, the provider's negotiated rates with insurance companies, the complexity of the service, and even market competition. Different providers may have varying overheads, equipment, and staffing costs, which are reflected in their pricing. Using tools that provide fee schedule lookups by location and CPT code, such as Payerprice, can help you compare these variations.
For a detailed breakdown of your specific insurance coverage, including deductibles, co-pays, and co-insurance for a particular service, your best first step is always to contact your insurance provider directly. However, to get a general understanding of typical costs for a service based on a CPT code and your location, which can help you estimate potential out-of-pocket expenses, you can also explore tools like Payerprice. Their fee schedule lookup tool can provide valuable insights into expected costs.