How Much Does Removal of Breast Lesion Cost?
Also known as: Removal of breast lesion (CPT 19120)
Excision of a breast mass or lump (lumpectomy) for diagnosis or treatment.
The total estimated cost of Removal of Breast Lesion (CPT 19120) is $1,028 to $1,670, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $408.
Total Estimated Cost of Care
This estimate includes hospital facility fees, anesthesia, and supplies .
Patient Guide: Removal of Breast Lesion
What you need to know before your appointment
What to Expect
Under local or general anesthesia, the surgeon removes the breast lump along with a margin of normal tissue. The tissue is sent to a lab for analysis.
How Long Does It Take?
30-60 minutes
Common Reasons Doctors Order This
Breast lump evaluation, breast cancer treatment, suspicious mammogram finding, fibroadenoma removal
How to Prepare
Fast if general anesthesia is planned. Wear a comfortable, supportive bra. Arrange a driver. You may have a drain for a day or two.
Procedures Commonly Done Together
These procedures are frequently performed alongside Removal of breast lesion
How to Reduce Your Cost for Removal of breast lesion
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
For this procedure, the office rate ($573) differs from the facility rate ($408). Ask if it can be done in an office setting.
- 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 (17.16) x CF ($33.40) = $573
Related Procedures
Similar procedures in the same category or body system
Frequently Asked Questions
How much does Removal of breast lesion cost?
The Medicare facility rate for Removal of breast lesion is $408. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).
How much does Removal of breast lesion cost without insurance?
Without insurance, the cost of Removal of breast lesion 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 Removal of breast lesion?
Most commercial health insurance plans and Medicare cover Removal of breast lesion 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.