Billing code 19306: Radical mastectomyMedicare rate & RVUs in Illinois
Reports an Urban-type radical mastectomy removing the breast, pectoral muscles, axillary nodes, and internal mammary nodes during extensive breast cancer surgery.
CMS doesn’t publish an office rate for 19306 in Illinois.
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 9 sections
What 19306 covers
This operation removes the breast along with the pectoral muscles and lymph nodes in both the axilla and internal mammary chain. It is an extensive breast cancer procedure typically performed by a breast surgeon or surgical oncologist in an operating room. The internal mammary node dissection distinguishes this Urban-type operation from other radical mastectomy approaches.
Report the procedure when the operative record supports removal of all these structures; the included nodal work is part of the operation, not a separate service for the same dissection. Documentation should identify the breast and specify removal of the pectoral muscles, axillary nodes, and internal mammary nodes. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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 19306 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $1,387.92 |
| East St. Louis | Unavailable | $1,302.96 |
| Rest Of Illinois | Unavailable | $1,228.71 |
| Suburban Chicago | Unavailable | $1,314.72 |
How the 19306 rate is calculated
Each of 19306’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 · 19306
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 17.68Practice expense 12.83Malpractice 4.73
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 19306
19306 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 19306
Radical mastectomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.71/0.19 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 19306
Radical 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
19306 without 50 · national facility
$1,177.05
Radical mastectomy
19306-50 · Bilateral: 150%
$1,765.58
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).
19306 compared with similar codes
Compare codes
19306 vs 19305 vs 19307 vs 19303: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 19305Mastectomy
- Both are radical mastectomy procedures involving pectoral muscles and axillary nodes. This code also includes internal mammary node removal.
- 19307Mastectomy
- The modified radical procedure preserves the pectoralis major muscle. This Urban-type procedure includes pectoral muscle removal and internal mammary node dissection.
- 19303Mastectomy
- Code 19303 describes complete breast removal without the pectoral muscle and nodal extent of this Urban-type operation.
19306 billing questions
How is this different from code 19305?
This Urban-type operation includes internal mammary node removal in addition to the breast, pectoral muscles, and axillary nodes. Code 19305 describes a radical mastectomy without that internal mammary node component.
How is this different from a modified radical mastectomy?
Code 19307 preserves the pectoralis major muscle and does not describe the internal mammary node dissection included in this operation. Use the operative details to distinguish the procedures.
Can the axillary or internal mammary node dissection be reported separately?
The node removal is included in this operation when performed as part of the mastectomy. Do not separately report the same dissection as an additional service.
What does the 90-day global period include?
It includes the day-before preoperative visit and 90 days of related postoperative care. CMS treats this as major surgery.
How should bilateral procedures be reported?
CMS specifies bilateral reporting with modifier 50, paid at 150%. The operative documentation should support that the procedure was performed on both breasts.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. 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
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