Partial Mastectomy Cost in Connecticut
Partial mastectomy
$4,633Hospital outpatient total2026 Medicare, physician + facility- ✓Your ZIP's wage-adjusted hospital and surgery centre rates
- ✓Five nearby hospitals by name, with CMS star ratings
- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
- ✓A private link you can reopen and share
- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
Connecticut Medicare physician rate (2026)
+6.5% vs nationalSingle statewide locality.
What the whole procedure costs
The rate above is the physician’s fee on its own. The facility bills separately, and for most procedures the facility is the larger half of the bill. These are 2026 national Medicare amounts.
Choosing a surgery centre over a hospital saves about $2,397 on the Medicare allowed amount for partial mastectomy. Ask whether your procedure can be done at an ambulatory surgery centre.
Medicare pays the hospital a single comprehensive amount for this procedure, covering the facility's share of the encounter including implants and supplies. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.
Your ZIP in Connecticut
Look up your ZIP code for local detail across Connecticut, including the New Haven and Hartford areas, Fairfield County and Stamford, and the quieter eastern and northwestern corners.
What partial mastectomy costs at hospitals near you
Everything above is a national average. The hospital you pick in Connecticut moves the bill more than anything else you control.
Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.
One-off payment, no account and no subscription. You get a private link and an email. No medical records and no insurance card, ever.
What these numbers are
Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery centre rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again.
National vs Connecticut
Where Connecticut ranks for this CPT
Partial Mastectomy and how Connecticut is priced
Despite sitting between two of the priciest metros in America, Connecticut is priced as one statewide Medicare locality, with geographic indices well above the national average. Every town from Stamford to Storrs shares the same adjustments, which are pushed up by the state's high wages, rents, and insurance costs. The uniform locality means Fairfield County's proximity to New York does not add a further Medicare premium beyond the statewide level. In practice Connecticut's Medicare-approved amounts rank among the higher states outside the biggest coastal cities.
Connecticut's hospital market has consolidated around a few large systems, and a major academic medical center in New Haven draws complex cases from across the state. Residents of Fairfield County routinely cross into New York for care, while some in the north lean toward Springfield or Boston providers. High commercial prices in the state make Medicare rates and transparent cash pricing especially useful comparison points here.
This procedure: A partial mastectomy, commonly called a lumpectomy, removes a breast tumor along with a rim of surrounding healthy tissue while preserving the rest of the breast. It is the surgical core of breast-conserving treatment for early-stage breast cancer. The operation is done under general anesthesia in a hospital or surgery center, usually takes one to two hours, and most patients go home the same day with soreness managed by oral medication.
What Is Partial Mastectomy?
A partial mastectomy, commonly called a lumpectomy, removes a breast tumor along with a rim of surrounding healthy tissue while preserving the rest of the breast. It is the surgical core of breast-conserving treatment for early-stage breast cancer. The operation is done under general anesthesia in a hospital or surgery center, usually takes one to two hours, and most patients go home the same day with soreness managed by oral medication.
What Affects the Cost
- –Lymph node procedures done at the same time, such as sentinel node biopsy with radioactive tracer and dye, are billed as separate surgical codes.
- –Pre-surgical wire or radioactive seed localization to mark a tumor that cannot be felt adds a radiology procedure charge.
- –The anesthesia team bills separately based on the length of the operation.
- –Pathology charges for examining the tumor, the margins, and any lymph nodes are substantial and billed by the lab.
- –Hospital outpatient departments usually cost more than ambulatory surgery centers for the identical operation.
- –If margins come back positive, a second re-excision surgery repeats many of these charges.
Questions to Ask Before Booking
- 1.Will you also do a sentinel lymph node biopsy, and what does that add to the total?
- 2.Is the surgery scheduled at a hospital or an ambulatory surgery center, and can I choose the cheaper setting?
- 3.What happens to my costs if the margins are positive and you need to operate again?
- 4.Are the anesthesiologist and pathology lab in my network?
- 5.Which follow-up visits are included in the 90-day global surgical period?
Other featured procedures in Connecticut
Partial Mastectomy in other states
Partial Mastectomy in Connecticut: questions
Connecticut is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 19301 is $673.80 in an office and $673.80 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.
Not on the physician fee schedule. Connecticut uses one locality, so the Medicare physician rate is the same from one end of the state to the other. What still changes is site of service (office vs hospital) and any facility fee the hospital bills on its own claim.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $135 for the office physician line or $135 for the hospital physician line in Connecticut. Medigap may cover that 20%. This is not the hospital facility fee.
No. $673.80 is only the physician's share. Adding Medicare's facility payment brings the total to about $4,633 in a hospital outpatient department, or about $2,236 at an ambulatory surgery centre. Anesthesia, pathology and other codes billed the same day are extra. Connecticut ranks #45 of 51 states on the physician line (7% above the national office rate of $632.61).