Partial Mastectomy Cost in Utah
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
Utah Medicare physician rate (2026)
-3.4% 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 Utah
Look up your ZIP for your part of Utah, whether Salt Lake City, Provo, Ogden, Logan, St. George, or the rural east and canyon country.
What partial mastectomy costs at hospitals near you
Everything above is a national average. The hospital you pick in Utah 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 Utah
Where Utah ranks for this CPT
Partial Mastectomy and how Utah is priced
Utah's fee schedule operates as a single statewide locality with geographic indices slightly below the national average, so the Wasatch Front and the remote canyon country share identical Medicare-approved amounts. Salt Lake City's growth into a major regional economy has not split the locality. From Logan to St. George, the same adjustments apply, making the statewide figures a clean guide for any Utah address. As usual, the choice between hospital-based and office-based settings will move a bill more than in-state geography can.
The Wasatch Front from Ogden through Salt Lake City to Provo concentrates nearly all of Utah's specialty care, anchored by an academic medical center and a large integrated system known nationally for cost discipline. Salt Lake City is also the referral hub for a huge intermountain region covering parts of Idaho, Wyoming, and Nevada. Fast-growing St. George serves the southwest corner, but rural and canyon-country residents still travel far for procedures.
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 Utah
Partial Mastectomy in other states
Partial Mastectomy in Utah: questions
Utah is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 19301 is $610.89 in an office and $610.89 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.
Not on the physician fee schedule. Utah 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 $122 for the office physician line or $122 for the hospital physician line in Utah. Medigap may cover that 20%. This is not the hospital facility fee.
No. $610.89 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. Utah ranks #22 of 51 states on the physician line (3% below the national office rate of $632.61).