Partial Mastectomy Cost in Missouri
Partial mastectomy
Missouri Medicare physician rate (2026)
-3.0% vs nationalAverage of 3 localities. Office range $600.35–$622.33.
Your ZIP in Missouri
Enter a ZIP code to see which Missouri locality covers you: metro St. Louis, metro Kansas City, or rest-of-state areas like Springfield, Columbia, Joplin, and the Bootheel.
What this number is
The figures on this page are 2026 Medicare physician allowed amounts for a specific CPT code: the professional fee, adjusted by geographic practice-cost indices. They are not a hospital chargemaster price, not your insurer's contracted rate, and not a quote. Hospital facility fees, anesthesia, implants, imaging reads, and pathology are billed separately when they apply.
National vs Missouri
Where Missouri ranks for this CPT
CPT 19301 by Missouri locality
| Locality | Office |
|---|---|
| metropolitan st. louis | $622.33 |
| metropolitan kansas city | $617.38 |
| rest of missouri | $600.35 |
PE GPCI ranges from 0.862 to 0.952 in Missouri. That index is why the same CPT is not one price statewide.
Partial Mastectomy and how Missouri is priced
Missouri is a three-locality state: metropolitan St. Louis and metropolitan Kansas City are each priced separately, and everywhere else falls into a rest-of-state locality with lower geographic adjustments. Both metro localities approve higher amounts than outstate Missouri, and the Kansas City locality applies only to the Missouri side of that metro, since the Kansas side prices under Kansas's statewide locality. Springfield, Columbia, and the rural counties all share rest-of-state factors. The metro-versus-outstate gap is the main pricing story here.
St. Louis and Kansas City hold the state's academic medical centers and most of its specialty depth, drawing patients from far beyond Missouri's borders, including southern Illinois and eastern Kansas. Outstate Missouri is served by regional hubs in Springfield, Columbia, and Cape Girardeau, with the Ozarks and Bootheel among the harder places to reach specialty care. Rural hospital viability has been a persistent concern across the state.
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 Missouri
Partial Mastectomy in other states
Partial Mastectomy in Missouri: questions
How much does partial mastectomy cost in Missouri?
The 2026 Medicare physician office rate for CPT 19301 averages $613.35 across 3 Missouri localities, from $600.35 in REST OF MISSOURI to $622.33 in METROPOLITAN ST. LOUIS. The hospital physician rate averages $613.35. Enter a ZIP for the exact locality.
Does the rate change inside Missouri?
Yes. CMS splits Missouri into 3 payment localities. For this CPT the office physician fee spans $21.98 from the lowest to highest locality. Enter a ZIP code to see which Missouri locality covers you: metro St. Louis, metro Kansas City, or rest-of-state areas like Springfield, Columbia, Joplin, and the Bootheel.
What will a Medicare patient owe for the physician fee?
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $123 for the office physician line or $123 for the hospital physician line in Missouri. Medigap may cover that 20%. This is not the hospital facility fee.
Is this the full partial mastectomy bill in Missouri?
No. $613.35 is the Medicare physician allowed amount for CPT 19301. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. Missouri ranks #23 of 51 states on this physician line (3% below the national office rate of $632.61).