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CPT code 19300: Gynecomastia surgery, male breast tissue removal2026 Medicare rate & RVUs in Vermont

Surgical removal of breast tissue for gynecomastia, typically performed to reduce glandular enlargement and improve chest contour.

CMS RVU26DEffective Oct 1, 2026One payment locality273 Medicare services in 2024

In Vermont, Medicare pays $613.09 for 19300 in the office and $403.77 when it’s performed in a hospital or facility.

$613.09Office (non-facility)
$403.77Hospital or facility
−3.8%vs the national office rate ($637.29)

Check a contract rate as a % of Medicare · 19300 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 19300 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Vermont
  2. What 19300 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 19300 covers

This operation removes breast tissue to treat gynecomastia, or enlargement of male breast tissue. A general or plastic surgeon may perform it in a hospital outpatient department or ambulatory surgery center, with the operative approach guided by the tissue and contour findings. The service is distinct from breast surgery for a tumor and from reduction surgery for generalized breast hypertrophy.

Report 19300 when the operation addresses gynecomastia; the operative report should support the diagnosis and describe the tissue removal performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For bilateral surgery reported with modifier 50, CMS pays at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. CMS does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Vermont compares for 19300

Across 109 of 109 payment localities, the office rate for 19300 runs from $557.92 in Arkansas to $824.91 in San Benito County, CA. Vermont pays $613.09. The RVUs are the same everywhere; the geographic indexes change the dollars.

19300 in Vermont vs other payment areas
  1. Vermont · this page$613.09
  2. Los Angeles, CA · California$708.37+$95.28
  3. Washington, DC area · District of Columbia$726.65+$113.56
  4. Miami, FL · Florida$716.46+$103.37
  5. Chicago, IL · Illinois$692.96+$79.87
  6. Manhattan, NY · New York$740.71+$127.62
  7. Alaska · Alaska$733.20+$120.11

Other areas in Vermont first, then benchmark localities. Bars start at $0.

Every other payment area

19300 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$566.77$381.77
ArkansasArkansas$557.92$376.31
ArizonaArizona$618.33$413.46
Bakersfield, CACalifornia$665.46$433.74
Chico, CACalifornia$662.17$430.44
El Centro, CACalifornia$662.37$430.65
Fresno, CACalifornia$662.17$430.44
Hanford, CACalifornia$662.17$430.44

19300 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$557.92

$743.54

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
19300 office rate range by state
State / territoryOffice rate rangeLocalities
AK$733.201
AL$566.771
AR$557.921
AZ$618.331
CA$662.17–$824.9129
CO$657.641
CT$681.871
DC$726.651
DE$628.991
FL$638.97–$716.463
GA$599.27–$652.712
GU$678.341
HI$678.341
IA$576.891
ID$582.081
IL$623.17–$692.964
IN$585.571
KS$576.551
KY$586.811
LA$586.85–$617.782
MA$654.32–$722.172
MD$640.79–$726.653
ME$588.10–$618.562
MI$605.63–$650.182
MN$621.131
MO$577.75–$617.023
MS$567.821
MT$637.211
NC$594.301
ND$613.281
NE$579.511
NH$649.621
NJ$687.12–$718.752
NM$610.231
NV$630.961
NY$604.09–$763.115
OH$600.741
OK$582.921
OR$623.59–$676.762
PA$600.31–$665.582
PR$641.351
RI$650.201
SC$599.011
SD$610.451
TN$580.011
TX$596.27–$657.618
UT$607.741
VA$618.20–$726.652
VI$641.351
VT$613.091
WA$652.34–$734.762
WI$591.521
WV$599.181
WY$626.781

See 19300 in every payment locality

How the 19300 rate is calculated

Each of 19300’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 19300

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.18

5.18 RVUs× 1.000 GPCI

Practice expense12.69

12.69 RVUs× 1.000 GPCI

Malpractice1.21

1.21 RVUs× 1.000 GPCI

Adjusted RVUs

19.0800

Conversion factor

$33.4009

Medicare rate

$637.29

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Vermont inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,685

Code
19300
Physician work
5.18
Practice expense
12.69
Malpractice
1.21

GPCI2026.csv

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office calculation for 19300 in Vermont
ComponentRVULocality factorAdjusted
Physician work5.18× 1.0005.1800
Practice expense12.69× 0.99012.5631
Malpractice1.21× 0.5060.6123
Total RVUs18.3554
Conversion factor× 33.4009

Office rate, Vermont$613.09

Office: (5.18 × 1 + 12.69 × 0.99 + 1.21 × 0.506) × $33.4009 = $613.09

Facility: (5.18 × 1 + 6.36 × 0.99 + 1.21 × 0.506) × $33.4009 = $403.77

Open 19300 in the RVU calculator

Payment rules and modifiers for 19300

19300 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 19300

Gynecomastia surgery, male breast tissue removal

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.71/0.19Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 19300

Gynecomastia surgery, male breast tissue removal

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

19300 without 50 · national office

$637.29

Gynecomastia surgery, male breast tissue removal

19300-50 · Bilateral: 150%

$955.94

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

Codes related to 19300

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 19300
CodeHow it relatesOffice range, Vermont
Used instead
19318Breast reduction, tissue removal and reshapingBreast reduction surgery for hypertrophy rather than an operation addressing gynecomastia.No office rate
19316Breast lift, ptosis correctionMastopexy addresses breast ptosis and contour rather than gynecomastia tissue removal.No office rate
Same family
19303Mastectomy, complete, without axillary dissectionA complete mastectomy code in the breast surgery family, used for a different operative indication.No office rate

How 19300 has changed in Vermont

19300 · Office / nonfacility

$613.09

Effective 2026-10-01

The base rate is $70.61 higher than on 2025-10-01, moving from $542.48 to $613.09 (13.0%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $542.48changed to$613.09

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.31 changed to 5.18
    • Practice expense RVU 10.90 changed to 12.69
    • Malpractice RVU 1.23 changed to 1.21
    • Practice expense GPCI 0.993 changed to 0.990
    • Malpractice GPCI 0.518 changed to 0.506

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $557.11changed to$542.48

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 10.86 changed to 10.90
    • Malpractice RVU 1.24 changed to 1.23

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $548.02changed to$557.11

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $574.74changed to$548.02

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 11.01 changed to 10.86
    • Practice expense GPCI 0.997 changed to 0.993
    • Malpractice GPCI 0.543 changed to 0.518

  5. January 1, 2023

    RVU23A

    $589.92changed to$574.74

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 11.02 changed to 11.01
    • Practice expense GPCI 1.001 changed to 0.997
    • Malpractice GPCI 0.569 changed to 0.543

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $581.24changed to$589.92

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 10.66 changed to 11.02
    • Malpractice RVU 1.19 changed to 1.24

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $556.19changed to$581.24

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 9.34 changed to 10.66
    • Malpractice RVU 1.18 changed to 1.19
    • Practice expense GPCI 1.008 changed to 1.001
    • Malpractice GPCI 0.582 changed to 0.569

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $540.77changed to$556.19

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.86 changed to 9.34
    • Practice expense GPCI 1.015 changed to 1.008
    • Malpractice GPCI 0.595 changed to 0.582

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $529.06changed to$540.77

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 8.55 changed to 8.86
    • Malpractice RVU 1.19 changed to 1.18

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $522.93changed to$529.06

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 8.41 changed to 8.55
    • Malpractice RVU 1.20 changed to 1.19
    • Practice expense GPCI 1.010 changed to 1.015
    • Malpractice GPCI 0.639 changed to 0.595

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $521.15changed to$522.93

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 8.38 changed to 8.41
    • Malpractice RVU 1.22 changed to 1.20
    • Practice expense GPCI 1.004 changed to 1.010
    • Malpractice GPCI 0.682 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $524.10changed to$521.15

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 8.43 changed to 8.38
    • Malpractice RVU 1.19 changed to 1.22

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $521.49changed to$524.10

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $512.88changed to$521.49

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.29 changed to 8.43
    • Malpractice RVU 1.08 changed to 1.19
    • Practice expense GPCI 1.006 changed to 1.004
    • Malpractice GPCI 0.618 changed to 0.682

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$512.88

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$613.09$403.77RVU26D
2026-07-01$613.09$403.77RVU26C
2026-04-01$613.09$403.77RVU26B
2026-01-01$613.09$403.77RVU26A
2025-10-01$542.48$406.93RVU25D
2025-07-01$542.48$406.93RVU25C
2025-04-01$542.48$406.93RVU25B
2025-01-01$542.48$406.93RVU25A
2024-10-01$557.11$413.65RVU24D
2024-07-01$557.11$413.65RVU24C
2024-04-01$557.11$413.65RVU24B
2024-03-09$557.11$413.65RVU24AR
2024-01-01$548.02$406.90RVU24A
2023-10-01$574.74$422.03RVU23D
2023-07-01$574.74$422.03RVU23C
2023-04-01$574.74$422.03RVU23B
2023-01-01$574.74$422.03RVU23A
2022-10-01$589.92$428.49RVU22D
2022-07-01$589.92$428.49RVU22C
2022-04-01$589.92$428.49RVU22B
2022-01-01$589.92$428.49RVU22A
2021-10-01$581.24$422.67RVU21D
2021-07-01$581.24$422.67RVU21C
2021-04-01$581.24$422.67RVU21B
2021-01-01$581.24$422.67RVU21A
2020-10-01$556.19$422.32RVU20D
2020-07-01$556.19$422.32RVU20C
2020-04-01$556.19$422.32RVU20B
2020-01-01$556.19$422.32RVU20A
2019-10-01$540.77$417.13RVU19D
2019-07-01$540.77$417.13RVU19C
2019-04-01$540.77$417.13RVU19B
2019-01-01$540.77$417.13RVU19A
2018-10-01$529.06$414.69RVU18D
2018-07-01$529.06$414.69RVU18C
2018-04-01$529.06$414.69RVU18B
2018-01-01$529.06$414.69RVU18AR1
2017-10-01$522.93$411.65RVU17D
2017-07-01$522.93$411.65RVU17C
2017-04-01$522.93$411.65RVU17B
2017-01-01$522.93$411.65RVU17A
2016-10-01$521.15$411.15RVU16D
2016-07-01$521.15$411.15RVU16C
2016-04-01$521.15$411.15RVU16B
2016-01-01$521.15$411.15RVU16A
2015-10-01$524.10$412.26RVU15D
2015-07-01$524.10$412.26RVU15C
2015-04-01$521.49$410.21RVU15B
2015-01-01$521.49$410.21RVU15A
2014-10-01$512.88$403.33RVU14D
2014-07-01$512.88$403.33RVU14C
2014-04-01$512.88$403.33RVU14B
2014-01-01$512.88$403.33RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 19300 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

19300 billing questions

How is 19300 different from breast reduction code 19318?

19300 is for surgery addressing gynecomastia. Code 19318 describes reduction surgery for breast hypertrophy, so the documented condition and operation guide the choice.

How should bilateral gynecomastia surgery be reported?

Report modifier 50 for bilateral surgery. CMS pays the bilateral procedure at 150%.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.

Can an assistant surgeon or co-surgeon be paid?

CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.

What happens when another procedure is performed in the same session?

Under the standard multiple procedure reduction, CMS pays the highest-valued procedure in full and pays other procedures at 50%.

What documentation supports reporting 19300?

Document gynecomastia as the condition treated and describe the breast tissue removal performed. The operative report should make clear that the surgery addressed gynecomastia rather than a tumor or generalized breast hypertrophy.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 19300PPRRVU2026_Oct_nonQPP.csv, line 1,685 (RVU26D)
Geographic factors for VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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