CPT 19110 Surgery - Integumentary
Nipple exploration Cost
Body System: Integumentary
Medicare Facility Rate
$356
CMS PFS CY2026
Medicare Non-Facility Rate
$534
Office/clinic setting
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
4.33
Work RVU
5.19
Facility PE RVU
1.13
Malpractice RVU
16.00
Total RVU
Frequently Asked Questions
How much does Nipple exploration cost?
The Medicare facility rate is $356. Commercial insurance typically pays 150-250% of Medicare rates (varies).
How much does Nipple exploration cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $356.