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Billing code 19305: MastectomyMedicare rate & RVUs

Reports removal of the breast, pectoral muscles, and axillary lymph nodes in a radical operation for extensive breast cancer.

CMS RVU26DEffective Oct 1, 2026109 payment localities155 Medicare services in 2024

Medicare pays $1,096.55 for 19305 nationally in a facility.

Medicare rate · 19305

Mastectomy

Swap in your local Medicare rate.

Work RVUs
17.02
Total RVUs
32.83
Global days
090

National rate · 2026

$1,096.55

Facility setting, before claim adjustments.

See every locality for 19305 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 19305 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 19305 covers

This operation removes the breast together with the pectoral muscles and axillary lymph nodes. It is an uncommon, extensive approach for breast cancer and is typically performed by a breast or surgical oncologist in a hospital operating room. The operative report should identify the structures removed and the extent of the axillary dissection; the documented procedure, rather than the cancer diagnosis alone, supports selection of this code.

Report the code when the operation includes the full radical extent, not for a mastectomy that preserves the pectoral muscles or removes only part of the breast. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires 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 19305 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

19305 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$985.23
Alaska*Unavailable$1,339.75
ArizonaUnavailable$1,063.61
ArkansasUnavailable$971.65
AtlantaUnavailable$1,133.83
AustinUnavailable$1,103.10
BakersfieldUnavailable$1,086.64
Baltimore/Surr. CntysUnavailable$1,168.24
BeaumontUnavailable$1,051.81
BrazoriaUnavailable$1,065.41

19305 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
19305 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 19305 rate is calculated

Each of 19305’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 · 19305

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 17.02Practice expense 11.42Malpractice 4.39

32.8300 adjusted RVUs×$33.4009 conversion factor=$1,096.55

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 19305

19305 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 19305

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 · 19305

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

19305 without 50 · national facility

$1,096.55

Mastectomy

19305-50 · Bilateral: 150%

$1,644.83

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

19305 compared with similar codes

Compare codes

19305 vs 19307 vs 19306 vs 19303 vs 19302: national Medicare rates

Swap in your local Medicare rate.

  • 19305
    Mastectomy · 17.02 wRVU
    —
  • 19307
    Mastectomy · 17.54 wRVU
    —
  • 19306
    Radical mastectomy · 17.68 wRVU
    —
  • 19303
    Mastectomy · 14.63 wRVU
    —
  • 19302
    Partial mastectomy · 13.64 wRVU
    —

How to choose

19307Mastectomy
Use the modified radical code when the breast and axillary nodes are removed but the pectoral muscles are preserved. This code represents removal of those muscles as well.
19306Radical mastectomy
The extended radical variant includes internal mammary lymph node removal in addition to the radical mastectomy extent.
19303Mastectomy
A complete mastectomy without the radical removal of pectoral muscles and axillary lymph nodes is reported with this code.
19302Partial mastectomy
This code represents partial breast removal with axillary lymph node removal, rather than removal of the entire breast and pectoral muscles.

Codes related to 19305

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

Codes related to 19305
CodeHow it relatesNational office range
Used instead
19307MastectomyModified radical operation removes axillary nodes while preserving the pectoral muscles.No office rate
19303MastectomyComplete breast removal without the radical operation's pectoral muscle and axillary node extent.No office rate
19302Partial mastectomyBreast-conserving operation with axillary lymph node removal rather than radical breast removal.No office rate
Same family
19306Radical mastectomyExtended radical variant also includes internal mammary lymph node removal.No office rate
Often billed with
19357Breast reconstructionTissue expander placement may be performed for immediate reconstruction in the same session.No office rate

19305 billing questions

How does this differ from a modified radical mastectomy?

This code includes removal of the pectoral muscles along with the breast and axillary lymph nodes. The modified radical procedure preserves the pectoral muscles.

Does this code include axillary lymph node removal?

Yes. Axillary lymph node removal is part of the radical operation represented by this code.

Can breast reconstruction be reported with this mastectomy?

Immediate reconstruction may be performed in the same session and reported separately when supported by the documented reconstructive service. For example, tissue expander placement may accompany mastectomy.

How is bilateral surgery reported?

CMS identifies this as a bilateral procedure; reporting 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 an assistant or co-surgeon be paid?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

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 19305PPRRVU2026_Oct_nonQPP.csv, line 1,689 (RVU26D)

Open CMS sourceHow we calculate rates

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