Price Checker / CPT 19120
CPT 19120 — Removal of breast lesion
2026 Medicare Physician Fee Schedule rates and hospital pricing data
$408
What Medicare pays in a hospital/ASC setting
$573
What Medicare pays in a physician's office
$11,134
Based on 32 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 19120
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Kearney County Hospital Minden, NE | $7,048 | — | 138593% |
| Person Memorial Hospital , NC | $34,328 | — | 5889% |
| Starr Regional Medical Center , TN | $33,695 | — | 5779% |
| Great Plains Health , NE | $31,094 | $17,824 | 5325% |
| Franciscan Health Crawfordsville , IN | $29,530 | $10,365 | 5052% |
| Ashley Regional Medical Center , UT | $20,175 | — | 3420% |
| Hill Regional Hospital Hillsboro, TX | $21,121 | — | 3032% |
| Pacifica Hospital of the Valley , CA | $15,293 | $15,293 | 2568% |
| Pacifica Hospital of the Valley Sun Valley, CA | $15,293 | — | 2568% |
| Castleview Hospital , UT | $14,814 | — | 2485% |
| Northern Light Blue Hill Hospital Blue Hill, ME | $683 | — | 2162% |
| Northern Light CA Dean Hospital Greenville Junction, ME | $683 | — | 2162% |
| Down East Community Hospital , ME | $12,922 | $9,692 | 2155% |
| Dimmit Regional Hospital Carrizo Springs, TX | $12,426 | — | 2068% |
| Down East Community Hospital Machias, ME | $12,922 | — | 1963% |
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About CPT 19120
CPT code 19120 refers to “Removal of breast lesion”. Under the 2026 Medicare Physician Fee Schedule, this procedure is reimbursed at $408 in a facility (hospital or ambulatory surgery center) and $573in 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
- Upload your bill— we'll identify this code and compare it against the rates shown above.
- Get a dispute letter— citing the Medicare rate and your hospital's own published pricing data.
- Negotiate or let us handle it — 25% of savings, no savings = no fee.