Price Checker / CPT 19100

CPT 19100Bx breast percut w/o image

2026 Medicare Physician Fee Schedule rates and hospital pricing data

Medicare Rate (Facility)

$62

What Medicare pays in a hospital/ASC setting

Medicare Rate (Office)

$163

What Medicare pays in a physician's office

Avg Hospital Charge

$5,397

Based on 20 hospital(s) in our database

What do these numbers mean?

The Medicare rateis what the federal government determines is a fair payment for this procedure. It's based on the Relative Value Unit (RVU) system, which accounts for physician work, practice expense, and malpractice cost. Hospitals and providers often charge 3-20x this amount. If your bill is significantly higher than the Medicare rate, you may have grounds to negotiate.

Hospital Charges for CPT 19100

From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.

HospitalGross ChargeCash Ratevs Medicare
Mercy Regional Medical Center

, CO

$10,834$4,3346533%
St. Anthony Summit Medical Center

, CO

$10,048$4,0196052%
Mena Hospital Commission dba Mena Regional Health System

, AR

$10,022$6,0136036%
Mercy Hospital South

, AR

$8,066$5,2434838%
Mercy Hospital Washington

, MO

$8,066$5,2434838%
Garden City Hospital

, MI

$7,310$1,8844376%
HSHS Holy Family Hospital

, IL

$5,613$4,0413337%
UPMC Wellsboro

, PA

$5,364$4,2913184%
UPMC Bedford

, PA

$5,305$4,2443148%
Miners Colfax Medical Center

, NM

$5,100$2,5503023%
Coffey County Hospital

, KS

$4,545$1,3642683%
Coffey County Hospital

Burlington, KS

$4,5452544%
Cumberland Healthcare

Cumberland, WI

$3,8982287%
Southwest Health System

, CO

$3,761$1,8812203%
Goodland Regional Medical Center

, KS

$3,371$3,0341964%

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About CPT 19100

CPT code 19100 refers to “Bx breast percut w/o image”. Under the 2026 Medicare Physician Fee Schedule, this procedure is reimbursed at $62 in a facility (hospital or ambulatory surgery center) and $163in a non-facility (physician's office) setting.

These rates are set by CMS (Centers for Medicare & Medicaid Services) and represent what the government considers a fair payment for this service. While commercial insurance typically pays somewhat more than Medicare, many hospitals charge significantly higher amounts — sometimes 10-50x the Medicare rate.

What to do if you were overcharged

  1. Upload your bill— we'll identify this code and compare it against the rates shown above.
  2. Get a dispute letter— citing the Medicare rate and your hospital's own published pricing data.
  3. Negotiate or let us handle it — 25% of savings, no savings = no fee.

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