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CPT code 19303: Mastectomy2026 Medicare rate & RVUs

Removal of the entire breast, including the nipple-areolar complex, without formal axillary dissection, for cancer treatment or risk-reducing surgery.

CMS RVU26DEffective Oct 1, 2026109 payment localities21.7K Medicare services in 2024

Medicare pays $915.85 for 19303 nationally in a facility.

Medicare rate · 19303

Mastectomy

Office or facility?

Work RVUs
14.63
Total RVUs
27.42
Global days
090

National rate · 2026

$915.85

Facility setting, before claim adjustments.

See every locality for 19303 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 19303 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 19303 covers

A simple complete mastectomy removes the breast tissue and nipple-areolar complex without a formal axillary lymph node dissection. Breast surgeons typically perform it in a hospital or ambulatory surgical setting for breast cancer treatment or risk-reducing surgery. Sentinel lymph node sampling may be performed during the same operative session, but it is distinct from a full axillary dissection.

Report 19303 when the operative record supports removal of the whole breast rather than a partial mastectomy; document the extent of tissue removal and any axillary procedure separately. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is 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.

Where 19303 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

19303 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$823.75
AlaskaUnavailable$1,123.57
ArizonaUnavailable$888.46
ArkansasUnavailable$812.53
Atlanta, GAUnavailable$947.33
Austin, TXUnavailable$920.06
Bakersfield, CAUnavailable$905.15
Baltimore area, MDUnavailable$975.40
Beaumont, TXUnavailable$879.78
Brazoria, TXUnavailable$889.49

19303 rates by state

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

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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.

View every state and territory as a table
19303 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 19303 rate is calculated

Each of 19303’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 · 19303

RVUs × geographic indexes × conversion factor

Office or facility?

Work14.63

14.63 RVUs× 1.000 GPCI

Practice expense9.04

9.04 RVUs× 1.000 GPCI

Malpractice3.75

3.75 RVUs× 1.000 GPCI

Adjusted RVUs

27.4200

Conversion factor

$33.4009

Medicare rate

$915.85

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

Payment rules and modifiers for 19303

19303 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 19303

Mastectomy

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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
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 · 19303

Mastectomy

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

19303 without 50 · national facility

$915.85

Mastectomy

19303-50 · Bilateral: 150%

$1,373.78

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

19303 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 19303

    Mastectomy14.63 wRVU

    Not priced

  • 19301

    Partial mastectomy9.88 wRVU

    Not priced

  • 19302

    Partial mastectomy13.64 wRVU

    Not priced

  • 19307

    Mastectomy17.54 wRVU

    Not priced

  • 19300

    Gynecomastia surgery5.18 wRVU

    $637.29

How to choose

19301Partial mastectomy
19301 is for partial breast removal; 19303 is for removal of the entire breast.
19302Partial mastectomy
19302 describes partial mastectomy with axillary lymphadenectomy, not a simple complete mastectomy.
19307Mastectomy
19307 is a modified radical mastectomy involving axillary dissection; 19303 describes complete breast removal without formal axillary dissection.
19300Gynecomastia surgery
19300 is for mastectomy for gynecomastia, rather than complete mastectomy for breast cancer treatment or risk reduction.

Codes related to 19303

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

Codes related to 19303
CodeHow it relatesNational office range
Used instead
19301Partial mastectomyReports partial breast removal rather than removal of the entire breast.No office rate
19302Partial mastectomyUsed for partial mastectomy with axillary lymphadenectomy.No office rate
19307MastectomyModified radical mastectomy includes a different extent of axillary surgery.No office rate
Often billed with
38525Axillary node biopsyDeep axillary lymph node biopsy may be performed during the same session.No office rate
19340Breast implantMay describe direct breast implant placement for immediate reconstruction.No office rate
19357Breast reconstructionMay describe tissue-expander placement for reconstruction at mastectomy.No office rate

19303 billing questions

How does 19303 differ from a partial mastectomy?

Use 19303 when the entire breast is removed. A partial mastectomy, reported with 19301, removes only part of the breast.

Does 19303 include axillary lymph node dissection?

No. A formal axillary dissection is not part of a simple complete mastectomy; choose the applicable mastectomy code when that dissection is performed. Sentinel node sampling is a distinct procedure.

Can sentinel lymph node biopsy be reported with 19303?

It may be reported separately when performed during the same operative session. The operative documentation should identify the node procedure and its extent.

How is bilateral 19303 reported for Medicare?

CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%.

What postoperative care is included?

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

Can breast reconstruction be performed and reported at the same session?

Immediate reconstruction may accompany mastectomy. The reconstruction code depends on the method, such as direct implant placement or tissue-expander placement, and the operative record should describe the work performed.

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 19303PPRRVU2026_Oct_nonQPP.csv, line 1,688 (RVU26D)

Open CMS sourceHow we calculate rates

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