Cost analysis for CPT 19301 — Partial removal of breast
Average Medicare Payment
$513.37
2023 data
Total Payments (2023)
$27.4M
Services (2023)
52.5K
Price Change (2014–2023)
+3.0%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $498.55 | $16.4M | 32.7K | — |
| 2015 | $506.82 | $18.4M | 35.9K | +1.7% |
| 2016 | $502.64 | $20.6M | 40.5K | -0.8% |
| 2017 | $492.87 | $21.5M | 43.2K | -1.9% |
| 2018 | $491.35 | $23.1M | 46.6K | -0.3% |
| 2019 | $504.06 | $25.5M | 50.1K | +2.6% |
| 2020 | $520.92 | $22.8M | 43.3K | +3.3% |
| 2021 | $521.18 | $27.0M | 51.1K | +0.0% |
| 2022 | $522.46 | $27.4M | 51.8K | +0.2% |
| 2023 | $513.37 | $27.4M | 52.5K | -1.7% |
The most expensive state pays 2.0x more than the cheapest for this procedure. AK averages $650.75 vs SD at $326.37.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $650.75 | $87.9K | 135 | 6 |
| NJ | $605.05 | $1.1M | 1.7K | 66 |
| DC | $595.61 | $162.6K | 273 | 6 |
| NY | $585.05 | $2.0M | 3.5K | 131 |
| MD | $581.17 | $1.0M | 1.8K | 49 |
| CO | $564.71 | $574.9K | 1.0K | 40 |
| IL | $550.08 | $1.2M | 2.1K | 79 |
| CT | $550.03 | $261.3K | 475 | 24 |
| FL | $546.59 | $1.9M | 3.5K | 118 |
| MA | $546.32 | $950.1K | 1.7K | 54 |
| PA | $543.58 | $1.3M | 2.4K | 91 |
| NH | $538.09 | $208.2K | 387 | 13 |
| VA | $532.70 | $1.3M | 2.4K | 68 |
| IN | $531.87 | $734.0K | 1.4K | 53 |
| ND | $529.81 | $76.8K | 145 | 6 |
| OR | $526.65 | $426.6K | 810 | 32 |
| CA | $522.16 | $2.9M | 5.6K | 186 |
| HI | $519.16 | $55.0K | 106 | 3 |
| WA | $515.57 | $666.1K | 1.3K | 48 |
| LA | $513.69 | $224.0K | 436 | 19 |
| OH | $513.05 | $684.9K | 1.3K | 58 |
| GA | $512.60 | $641.8K | 1.3K | 56 |
| AR | $511.58 | $255.3K | 499 | 18 |
| DE | $507.15 | $144.0K | 284 | 7 |
| MI | $505.21 | $597.7K | 1.2K | 49 |
| NM | $504.50 | $97.9K | 194 | 8 |
| KY | $499.27 | $260.1K | 521 | 19 |
| MN | $496.47 | $223.9K | 451 | 25 |
| TX | $496.29 | $1.5M | 3.1K | 116 |
| OK | $495.00 | $270.3K | 546 | 15 |
| MO | $493.92 | $449.5K | 910 | 34 |
| TN | $493.22 | $582.0K | 1.2K | 40 |
| MT | $491.22 | $120.8K | 246 | 10 |
| VT | $488.62 | $63.5K | 130 | 6 |
| NC | $488.05 | $1.0M | 2.1K | 66 |
| SC | $479.30 | $548.3K | 1.1K | 37 |
| AL | $475.53 | $225.4K | 474 | 21 |
| WI | $472.56 | $308.1K | 652 | 30 |
| AZ | $468.65 | $706.3K | 1.5K | 45 |
| UT | $454.98 | $153.3K | 337 | 15 |
| RI | $446.72 | $96.5K | 216 | 9 |
| WV | $444.46 | $55.1K | 124 | 7 |
| NE | $443.98 | $154.1K | 347 | 11 |
| KS | $439.13 | $243.3K | 554 | 19 |
| ID | $419.90 | $147.4K | 351 | 15 |
| MS | $414.45 | $141.7K | 342 | 11 |
| ME | $412.83 | $125.9K | 305 | 12 |
| IA | $409.37 | $228.8K | 559 | 20 |
| NV | $407.03 | $100.1K | 246 | 6 |
| SD | $326.37 | $91.1K | 279 | 8 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Aspen Surgery Center, Llc | Ambulatory Surgical Center | CA | $101.6K | 99 | $1026.49 |
| Johns Hopkins Surgery Centers Series | Ambulatory Surgical Center | MD | $92.8K | 129 | $719.14 |
| Huntington Ambulatory Surgery Center, Llc | Ambulatory Surgical Center | CA | $89.7K | 92 | $975.37 |
| Sansum Clinic | Ambulatory Surgical Center | CA | $78.7K | 84 | $937.33 |
| Monterey Peninsula Surgery Center Llc | Ambulatory Surgical Center | CA | $76.4K | 61 | $1251.74 |
| Sharla Patterson | General Surgery | FL | $73.5K | 125 | $588.18 |
| Michele Gadd | Surgical Oncology | MA | $73.0K | 128 | $570.68 |
| Alexander Swistel | General Surgery | NY | $72.4K | 112 | $646.13 |
| Fredericksburg Ambulatory Surgery Center, Llc | Ambulatory Surgical Center | VA | $69.2K | 97 | $713.07 |
| Baptist Surgery And Endoscopy Centers Llc | Ambulatory Surgical Center | FL | $68.2K | 93 | $733.42 |
| Michelle Specht | Surgical Oncology | MA | $61.8K | 110 | $561.66 |
| Cares Surgicenter Llc | Ambulatory Surgical Center | NJ | $61.3K | 66 | $928.64 |
| Coastal Surgical Specialists, Inc. | Ambulatory Surgical Center | CA | $59.4K | 70 | $849.08 |
| Methodist Surgery Center Germantown Lp | Ambulatory Surgical Center | TN | $58.8K | 86 | $684.27 |
| Joseph Colletta | General Surgery | FL | $57.9K | 100 | $579.02 |
| Stephanie Byrum | General Surgery | AZ | $53.8K | 104 | $517.73 |
| Abington Surgical Center | Ambulatory Surgical Center | PA | $52.7K | 70 | $753.57 |
| Lynn Canavan | Surgical Oncology | TX | $52.0K | 104 | $499.91 |
| Catherine Pesce | Surgical Oncology | MD | $51.7K | 88 | $587.72 |
| Baptist-Emsc Lp | Ambulatory Surgical Center | TN | $51.2K | 76 | $673.32 |
Based on the data, CPT 19301 shows a 2.0x variation in pricing across states — moderate variation by Medicare standards.
Costs have increased 3.0% since 2014. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.