What do doctors typically charge for Removal of Growth of Breast Identified by X-ray Marker?

The nationwide median physician charge for Removal of Growth of Breast Identified by X-ray Marker (CPT 19125) is $1646.00. Doctor billed charges vary based on geographic region, setting, and overhead.

What is the standard insurance baseline for CPT 19125?

The standard insurance baseline reimbursement rate is $453.15. This represents the customary allowable amount established across standard fee schedules.

Home/Procedures/Removal of Growth of Breast Identified by X-ray Marker

CPT 19125Medical Service

Removal of Growth of Breast Identified by X-ray Marker

Removal of growth of breast identified by x-ray marker, first growth. Clinical pricing breakdown and utilization metrics across 185 practicing doctors nationwide.

$1646.00

Peer Median Charge

Gross billed rate

$453.15

Standard Baseline

Customary allowable

3.6x

National Markup

Charge vs baseline

185

Active Physicians

Billing this code

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Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $1646.00. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $453.15 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:

"Does Dr. [Name] participate in my specific insurance plan network?"
"What is the total self-pay or cash rate for code 19125 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"