No office rate
Use 19302 when breast-conserving surgery is performed with axillary node dissection. Use 19307 when the breast is removed with the nodal dissection.
On this page
CMS RVU26D · Effective 2026-10-01
19307 Mastectomy Medicare reimbursement rates in Hawaii
Reports breast removal for cancer with axillary lymph node dissection, typically when the operation includes both breast tissue and regional nodal surgery. Compare 19307 office and facility rates across CMS payment localities in Hawaii.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 19307 in Hawaii?
Hawaii has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1116.27
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Breast surgery
About 19307: Modified radical breast mastectomy
Reports breast removal for cancer with axillary lymph node dissection, typically when the operation includes both breast tissue and regional nodal surgery.
A surgeon removes breast tissue and performs an axillary lymph node dissection, usually as treatment for breast cancer. The procedure is generally performed in a hospital operating room. The modified radical approach removes the breast and axillary nodes while preserving the pectoral muscles; the nodal dissection is part of this operation, not a separate service for the same work.
Report the code when the operative record supports both breast removal and axillary node dissection, rather than a simple mastectomy or partial breast removal. Document the side and the extent of the operation. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during the 90 days after surgery. For bilateral surgery, modifier 50 is paid at 150%. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 19307
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU17.54 · 52%
- Practice expense (office) RVU11.66 · 35%
- Malpractice RVU4.53 · 13%
3.4K
Medicare services in 2024 · #2092 by national volume
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.
19307 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
19303 describes breast removal without the axillary node dissection included in 19307. The operative report should establish whether nodal dissection was performed.
No office rate
19305 is for a radical operation that includes removal of pectoral muscles. 19307 describes the modified radical approach, which preserves them.
No office rate
19306 identifies the Urban-type radical operation, a distinct, more extensive radical approach. Use 19307 for the modified radical operation with axillary dissection.
Compare 19307 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$1116.27
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 19307 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
1,691
- Code
- 19307
- Physician work
- 17.54
- Practice expense
- 11.66
- Malpractice
- 4.53
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 17.54 | × 1.000 | 17.5400 |
| Practice expense | 11.66 | × 1.137 | 13.2574 |
| Malpractice | 4.53 | × 0.579 | 2.6229 |
| Total RVUs | 33.4203 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$1116.27
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 17.54 | 1 |
| Practice expense | 11.66 | 1.137 |
| Malpractice | 4.53 | 0.579 |
(17.54 × 1 + 11.66 × 1.137 + 4.53 × 0.579) × $33.4009 = $1116.27
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
19307 billing questions
How does this differ from a simple mastectomy?
This code includes axillary lymph node dissection along with breast removal. A simple mastectomy does not include that nodal operation.
Can the axillary dissection be reported separately?
The axillary lymph node dissection is included in this operation. Do not separately report the same nodal work as though it were a separate procedure.
What supports reporting this code instead of partial mastectomy with node removal?
The operative report should show removal of the breast, not breast-conserving excision, together with axillary lymph node dissection.
How is bilateral surgery reported?
Use modifier 50 for bilateral surgery. CMS pays bilateral procedures at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days after surgery.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,68819303,,Mast simple complete,A,,14.63,9.04,NA,9.04,,3.75,27.42,27.42,0,090,0.10,0.71,0.19,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,68919305,,Mast radical,A,,17.02,11.42,NA,11.42,,4.39,32.83,32.83,0,090,0.10,0.71,0.19,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,69019306,,Mast rad urban type,A,,17.68,12.83,NA,12.83,,4.73,35.24,35.24,0,090,0.10,0.71,0.19,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,69119307,,Mast mod rad,A,,17.54,11.66,NA,11.66,,4.53,33.73,33.73,0,090,0.10,0.71,0.19,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,69219316,,Mastopexy,A,,10.81,8.89,NA,8.89,,2.13,21.83,21.83,0,090,0.10,0.71,0.19,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,69319318,,Breast reduction,A,,15.63,10.76,NA,10.76,,2.96,29.35,29.35,0,090,0.10,0.71,0.19,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,69419325,,Breast augmentation w/implt,A,,7.92,7.55,NA,7.55,,1.48,16.95,16.95,0,090,0.10,0.71,0.19,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014