Price Checker / CPT 19126
How much does Excision Addl Breast Lesion cost?
CPT 19126 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is around 71x the fair price — among the most extreme markups. Dispute this.
Fair price
$220–$430
What this should cost
With insurance
~$2,550
Typical out-of-pocket
Overcharged if over
$540
Push back above this
The average hospital charge of $23,466 is $23,136 over the fair price (about 71x the fair rate).
What hospitals charge for Excision Addl Breast Lesion
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| John Muir Health Behavioral Health Center , CA | $67,837 | $30,526 | 47022% |
| John Muir Health Concord Medical Center , CA | $67,837 | $30,526 | 47022% |
| Lenox Hill Hospital NEW YORK, NY | — | $4,595 | 16626% |
| Staten Island University Hospital STATEN ISLAND, NY | — | $4,595 | 13014% |
| "Cohen Children's Medical Center" , NY | — | $4,595 | 12945% |
| Long Island Jewish Medical Center NEW HYDE PARK, NY | — | $4,595 | 12945% |
| Zucker Hillside Hospital , NY | — | $4,595 | 12945% |
| North Shore University Hospital MANHASSET, NY | — | $4,595 | 12512% |
| Mather Hospital , NY | — | $4,595 | 12228% |
| Long Island Jewish Valley Stream , NY | — | $4,595 | 11770% |
| South Shore University Hospital , NY | — | $4,595 | 11770% |
| Syosset Hospital , NY | — | $4,595 | 11770% |
| Claiborne Memorial Medical Center HOMER, LA | $3,300 | $3,300 | 2192% |
| Richardson Medical Center RAYVILLE, LA | $3,084 | $2,313 | 2042% |
Were you billed for this procedure?
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About Excision Addl Breast Lesion
CPT code 19126 refers to excision addl breast lesion (billing description: "Excision addl breast lesion"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $144 in a facility (hospital or surgery center) and $144 in a doctor's office.
The Medicare rate is the closest thing to an objective "what this work is actually worth." A fair cash price for the uninsured is generally 1.5–3x that rate. Hospital sticker (gross) charges are often far higher — but almost nobody actually pays them.
What to do if you were overcharged
- 1Send us your bill — we'll identify this code and compare it against the rates shown above.
- 2Get a dispute letter — citing the Medicare rate and your hospital's own published pricing data.
- 3We negotiate for you — 25% of savings, no savings = no fee.