How Much Does a Mastectomy Cost in 2026?
Without insurance, a mastectomy typically costs $15,000 to $55,000, depending on whether it is one breast or both, whether lymph nodes are removed, and whether you stay overnight. With insurance, a breast-cancer patient usually pays up to their annual out-of-pocket maximum (commonly $3,000 to $9,100 for the year).
Federal law: if your plan covers the mastectomy, it must also cover reconstruction
Under the Women's Health and Cancer Rights Act (WHCRA) of 1998, any group or individual health plan that covers a mastectomy is required by federal law to also cover, at the same deductible and coinsurance as the plan's other benefits:
- All stages of breast reconstruction on the breast that was removed
- Surgery on the other breast to make the two breasts symmetrical
- External breast prostheses, including one silicone replacement every 24 months, and post-surgical bras
- Treatment of physical complications at any stage, including lymphedema
Many women are never told this. It applies even if the mastectomy was not for cancer (for example, a preventive mastectomy for a BRCA mutation). Reconstruction can also happen years later and is still covered. Source: U.S. Department of Labor (EBSA) and the American Cancer Society.
- The biggest cost drivers are one breast vs. both, whether lymph nodes are removed, and how long you stay. A mastectomy is increasingly done as outpatient or a single overnight ("same-day mastectomy"), which cuts the facility fee; a longer stay or drain management adds cost.
- Reconstruction is a choice, not a requirement. Choosing to "go flat," done well, is a defined, covered procedure called aesthetic flat closure, not just skipping reconstruction. You are entitled to ask for it, and some patients are never offered it.
- A sentinel lymph node biopsy (CPT 38525) and the pathology that reads your tissue are billed separately from the mastectomy itself, so expect more than one line on the bill.
Mastectomy Cost by Type
Cash / self-pay price ranges for the surgery itself (before reconstruction). Whether it is one breast or both, and whether you stay overnight, are the biggest factors.
| Type | Cash price |
|---|---|
| Simple / total mastectomy, one breast (often outpatient) | $15,000 to $30,000 |
| Mastectomy with sentinel lymph node biopsy | $18,000 to $38,000 |
| Modified radical mastectomy (with axillary nodes) | $22,000 to $45,000 |
| Bilateral (double) mastectomy | $25,000 to $55,000+ |
Note on reconstruction: these ranges are the mastectomy only. Breast reconstruction adds much more (often $5,000 to $50,000+ depending on implant vs. your own tissue), and under WHCRA it is covered if your plan covers the mastectomy. If a lump can be removed without taking the whole breast, a lumpectomy is a separate, usually lower-cost option. For the full picture of a cancer course, see cancer treatment cost.
Want to know what your mastectomy should cost you?
Costs vary substantially by procedure, location, facility, and insurance. Get a personalized estimate based on your situation.
Already have a bill? Send it to CareRoute and we will work to reduce it. 64% of cases reduced.
What Makes Up the Bill
Total billed before insurance is typically $25,000 to $60,000+ for a cancer mastectomy. It is usually split across:
The single biggest lever is the facility fee, which is why an outpatient or single-overnight mastectomy is far cheaper than a multi-day inpatient stay. Each additional hospital night adds roughly $2,000 to $4,000. The sentinel node biopsy and pathology are their own line items, so a bill with several charges for one surgery is normal, not a duplicate error.
With vs. Without Insurance
Without insurance (self-pay)
$15,000 to $55,000
Ask for the cash or prompt-pay price up front, and request a written Good Faith Estimate (the law requires one for self-pay patients). Removing both breasts or adding lymph node surgery raises the total. Reconstruction is extra.
With insurance (out of pocket)
Up to your OOP max
A medically necessary mastectomy is covered by essentially all commercial plans, Medicare, and Medicaid. Because a cancer course stacks surgery, pathology, imaging, and often chemo or radiation in one plan year, most patients hit their annual out-of-pocket maximum (ACA caps it at $9,100 for an individual in 2026, and many plans are lower). Confirm the surgeon, facility, AND anesthesiologist are all in-network, and get prior authorization.
Prices vary widely by region and facility. Within one metro, hospital-reported cash prices for the same mastectomy code can differ several times over, so shopping 3-4 facilities and asking each for an all-in price matters more than your region alone.
How to Pay Less
Use your WHCRA rights, and know aesthetic flat closure is covered too
If your plan covers the mastectomy, federal law (WHCRA) requires it to cover reconstruction, surgery on the other breast for symmetry, prostheses, and lymphedema treatment at your normal deductible and coinsurance. If you do not want reconstruction, ask your surgeon for a proper aesthetic flat closure rather than a basic closure, so the result is deliberate and smooth. It is a recognized surgical option, not a cost upgrade.
Ask whether it can be outpatient or a single overnight
Many mastectomies, including some with sentinel node biopsy, are now done as same-day or single-overnight surgery with a drain you manage at home. Avoiding extra inpatient nights is one of the largest savings, often several thousand dollars. Ask your surgeon what is safe for your case.
Request an all-in bundled cash price in writing
Uninsured patients are billed the full chargemaster rate, often 2-3x the negotiated rate. Ask for a single bundled Good Faith Estimate that includes the surgeon, anesthesia, facility, lymph node biopsy, and pathology so there are no surprise add-ons. Hospitals commonly cut 30-60% for cash paid upfront.
Tap breast-cancer grants and lymphedema coverage
Groups like the Patient Advocate Foundation, CancerCare, and the Pink Fund offer grants for treatment and living costs. And since January 1, 2024, the Lymphedema Treatment Act means Medicare Part B covers compression garments and supplies (20% coinsurance, with a prescription and diagnosis), which matters because lymphedema is a common, lifelong complication with ongoing costs.
Check hospital charity care, or get the bill reduced
Uninsured or lower income? Many hospitals offer free or discounted care. Use the charity care finder to see if you qualify nearby. Already billed? CareRoute Bill Defense reviews and negotiates it down, with no fee unless we save you money.
Frequently Asked Questions
Does insurance have to cover breast reconstruction after a mastectomy?
Yes. Under the Women's Health and Cancer Rights Act (WHCRA) of 1998, if your health plan covers a mastectomy it must also cover all stages of breast reconstruction, surgery on the other breast for symmetry, external breast prostheses, and treatment of complications like lymphedema, all at the same deductible and coinsurance as your other benefits. It applies even if the mastectomy was preventive rather than for cancer, and reconstruction done years later is still covered. Medicare and most Medicaid programs follow the same rule.
Is it cheaper to not get reconstruction?
Reconstruction is a personal choice, not a requirement, and skipping it avoids the added reconstruction cost. If you choose not to reconstruct, ask your surgeon specifically for an aesthetic flat closure, which is a recognized surgical technique for a smooth, flat result rather than just a basic closure. It is covered the same way the mastectomy is. Whether you reconstruct should be your decision about your body, not a decision forced by cost.
Why does my bill have several separate charges for one surgery?
That is normal. The mastectomy (CPT 19303 or 19307), the sentinel lymph node biopsy (CPT 38525), the pathology that reads your tissue, the anesthesia, and the facility are each billed separately, sometimes by different companies. A bill with multiple line items for one operation is usually not a duplicate error. It is still worth reviewing each line, because errors and out-of-network surprise charges do happen.
Does Medicare cover compression garments for lymphedema?
Yes, as of January 1, 2024. The Lymphedema Treatment Act added compression garments and supplies as a covered Medicare Part B benefit. With a prescription and a lymphedema diagnosis, Medicare pays 80% and you owe about 20% coinsurance after the Part B deductible. This matters because lymphedema is a common, lifelong complication of mastectomy and lymph node surgery, and the garments are an ongoing cost that used to come fully out of pocket.
How much does Medicare pay the surgeon for a mastectomy?
Under the 2026 Medicare Physician Fee Schedule, the surgeon's professional fee is about $916 for a simple/total mastectomy (CPT 19303), about $1,127 for a modified radical mastectomy (CPT 19307), and about $431 for a sentinel lymph node biopsy (CPT 38525). The hospital facility fee is billed separately and is much larger, so Medicare's total approved amount is higher than the surgeon fee alone. You are generally responsible for about 20% coinsurance after the Part B deductible, which a Medigap plan can cover.
More Cost Guides
Sources
- CMS 2026 Physician Fee Schedule (CPT 19303/19307/38525, $33.4009 conversion factor), surgeon professional fees from total RVUs
- U.S. Department of Labor (EBSA) and American Cancer Society on the Women's Health and Cancer Rights Act (WHCRA) of 1998
- Lymphedema Treatment Act, Medicare Part B coverage of compression garments effective January 1, 2024
- MDsave and GoodRx bundled and cash pricing for mastectomy and double mastectomy
- Healthcare Bluebook and FAIR Health fair-price data, hospital price-transparency (machine-readable file) cash rates, and HealthCentral breast-cancer cost reporting
Prices are national estimates for 2026 and vary by location, provider, surgery type, and your specific plan. This page is cost information, not medical advice. Last updated October 3, 2026.