CPT19301

Partial Mastectomy Cost in Georgia

Partial mastectomy

$4,633Hospital outpatient total2026 Medicare, physician + facility
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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Georgia Medicare physician rate (2026)

+1.1% vs national

Average of 2 localities. Office range $625.38–$654.14.

Georgia (Hospital)
$639.76
Facility physician fee
Private plan est.
$832–$1,280
~130–200% of Medicare
Cash / self-pay est.
$512–$960
~80–150% of Medicare

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.

Surgery centre, total
$2,236
$633 physician + $1,603 facility
Physician fee alone
$633
Only 14% of the hospital total

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 Georgia

Look up your ZIP to see whether Atlanta-area or rest-of-state pricing applies, from the metro counties to Savannah, Augusta, Columbus, Macon, and rural south Georgia.

What partial mastectomy costs at hospitals near you

Everything above is a national average. The hospital you pick in Georgia moves the bill more than anything else you control.

Locked

Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

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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 Georgia

National office$632.61
National hospital (physician)$632.61
Georgia vs nationalwithin 2% of the national office rate of $632.61

Where Georgia ranks for this CPT

Rank (lowest physician fee first)#37 of 51
Lowest stateArkansas ($560.76)
Highest stateAlaska ($773.68)

CPT 19301 by Georgia locality

LocalityOffice
atlanta$654.14
rest of georgia$625.38

PE GPCI ranges from 0.892 to 1.016 in Georgia. That index is why the same CPT is not one price statewide.

Partial Mastectomy and how Georgia is priced

Georgia divides into an Atlanta metro locality and a rest-of-state locality, so the fee schedule itself recognizes the cost gap between the capital region and the rest of the state. Atlanta's higher wages and rents translate into higher Medicare-approved amounts inside its locality, while Savannah, Augusta, Columbus, Macon, and rural Georgia share the lower rest-of-state pricing. The split is one of the cleaner examples of a two-tier state in the fee schedule. Patients near the locality boundary can see different approved amounts a short drive apart.

Metro Atlanta concentrates the state's academic medicine and most of its subspecialists, drawing referrals from across the Southeast. Outside the metro, south Georgia has seen repeated rural hospital closures, leaving longer trips for even routine procedures in some counties. Augusta and Savannah serve as important secondary hubs, and border residents sometimes cross into Chattanooga, Tallahassee, or Jacksonville for care.

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?

Partial Mastectomy in Georgia: questions

The 2026 Medicare physician office rate for CPT 19301 averages $639.76 across 2 Georgia localities, from $625.38 in REST OF GEORGIA to $654.14 in ATLANTA. The hospital physician rate averages $639.76. Enter a ZIP for the exact locality.

Yes. CMS splits Georgia into 2 payment localities. For this CPT the office physician fee spans $28.76 from the lowest to highest locality. Look up your ZIP to see whether Atlanta-area or rest-of-state pricing applies, from the metro counties to Savannah, Augusta, Columbus, Macon, and rural south Georgia.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $128 for the office physician line or $128 for the hospital physician line in Georgia. Medigap may cover that 20%. This is not the hospital facility fee.

No. $639.76 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. Georgia ranks #37 of 51 states on the physician line (within 2% of the national office rate of $632.61).

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.