How can I find out the cost of a medical procedure before I have it?

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.

What does a CPT code mean and how is it used in medical billing?

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.

Why do medical costs vary so much between different providers or locations?

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.

Where can I get a detailed breakdown of what my insurance will cover for a specific service?

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.

CPT 19303 Fee Schedule

Last Verified: September 2026

Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.

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	None 50 - Bilateral Procedure LT - Left side of body
Complexity Level	High
Medicare Fee Schedule	View Medicare rates for 19303
Medicaid Fee Schedule	View Medicaid rates for 19303

National average reimbursement for CPT 19303 by major payers:

$1,232.47

$1,234.89

$1,312.32

$1,549.32

Compare published rates across providers.

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CPT 19303

5 of 25 sample ratesHigher to lower in this preview

Manuel Rodriguez Montana
University Physicians Incorporated
COPediatric Emergency Medicine (Pediatrics) PhysicianNPI 1750637906Tax ID 74-2161737
$4,160.79Published rate
Angela Peltz
University Physicians Incorporated
COMedical Physician AssistantNPI 1689759334Tax ID 74-2161737
$3,265.37Published rate
Spine And Pain Physicians Surgery Center, LLC
Spine And Pain Physicians Surgery Center LLC
TNAmbulatory Surgical Clinic/CenterNPI 1770837866Tax ID 45-4831116
$1,927.00Published rate
Andrew Federer
Poudre Valley Medical Group LLC
NCOrthopaedic Hand Surgery PhysicianNPI 1780003954Tax ID 80-0348943
$1,607.56Published rate
Podiatry Group Of Annapolis Ambulatory Surgical Center, Podiatry Group Of Annapolis Ambulatory Surgical Center LLC
Podiatry Group Of Annapolis Ambulatory Surgical Center
MDAmbulatory Surgical Clinic/CenterNPI 1285736207Tax ID 52-2197193
$753.00Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 19303 vs. Other Surgical Procedures on the Integumentary System Codes

The CPT 19303 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 19303 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

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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CPT 19303 Fee Schedule

Manuel Rodriguez Montana

Angela Peltz

Spine And Pain Physicians Surgery Center, LLC

Andrew Federer

Podiatry Group Of Annapolis Ambulatory Surgical Center, Podiatry Group Of Annapolis Ambulatory Surgical Center LLC