CPT19301

Partial Mastectomy Cost in North Dakota

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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North Dakota Medicare physician rate (2026)

-8.0% vs national

Single statewide locality.

North Dakota (Hospital)
$582.22
Facility physician fee
Private plan est.
$757–$1,164
~130–200% of Medicare
Cash / self-pay est.
$466–$873
~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 North Dakota

Enter a ZIP code for your part of North Dakota, whether Fargo, Bismarck, Grand Forks, Minot, or the farm and oil country in between.

What partial mastectomy costs at hospitals near you

Everything above is a national average. The hospital you pick in North Dakota 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 North Dakota

National office$632.61
National hospital (physician)$632.61
North Dakota vs national8% below the national office rate of $632.61

Where North Dakota ranks for this CPT

Rank (lowest physician fee first)#13 of 51
Lowest stateArkansas ($560.76)
Highest stateAlaska ($773.68)

Partial Mastectomy and how North Dakota is priced

North Dakota's entire fee schedule flows through one statewide locality whose geographic indices sit near the national floor, lifted partly by the work index floor CMS applies to low-cost states. Fargo and a prairie town on the Canadian border publish identical Medicare-approved amounts. With no metro large enough to justify its own locality, the state is among the most straightforward in the country for Medicare pricing. Oil-patch growth in the west changed local economies but not the fee schedule structure.

Fargo and Bismarck are the state's two care anchors, each dominated by large regional systems that also reach into Minnesota, South Dakota, and Montana, with Grand Forks and Minot serving their own areas. Much of rural North Dakota depends on critical access hospitals, and winter travel adds a genuine planning constraint. Some eastern residents cross into Minnesota for care, particularly toward Fargo-Moorhead's twin market.

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 North Dakota: questions

North Dakota is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 19301 is $582.22 in an office and $582.22 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.

Not on the physician fee schedule. North Dakota 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 $116 for the office physician line or $116 for the hospital physician line in North Dakota. Medigap may cover that 20%. This is not the hospital facility fee.

No. $582.22 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. North Dakota ranks #13 of 51 states on the physician line (8% below 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.