No office rate
Choose 19302 when the operation includes axillary lymphadenectomy with partial breast removal. Choose 19301 for partial breast removal without that dissection.
On this page
CMS RVU26D · Effective 2026-10-01
19302 Partial mastectomy Medicare reimbursement rates in Iowa
Reports breast-conserving excision combined with axillary lymph node dissection, commonly performed for breast cancer when both procedures are completed in one operation. Compare 19302 office and facility rates across CMS payment localities in Iowa.
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 19302 in Iowa?
Iowa 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
$771.69
1 of 1 localities have a supported rate.
Payment area: Iowa
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 19302: Partial mastectomy with axillary lymphadenectomy
Reports breast-conserving excision combined with axillary lymph node dissection, commonly performed for breast cancer when both procedures are completed in one operation.
The surgeon removes a portion of the breast, such as a tumor-bearing segment, and performs an axillary lymphadenectomy during the same operation. This breast-conserving cancer surgery is typically performed by a breast or general surgeon in a hospital or ambulatory surgical setting. It represents a more extensive service than breast excision alone because the axillary node dissection is part of the operation.
Select this code when the operative report supports both partial breast removal and axillary lymphadenectomy; a partial mastectomy with sentinel node evaluation alone is not the same service. Document the breast tissue removed and the axillary dissection performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For same-session multiple procedures, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
CMS billing rules for 19302
- 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 RVU13.64 · 53%
- Practice expense (office) RVU8.82 · 34%
- Malpractice RVU3.51 · 14%
1.9K
Medicare services in 2024 · #2482 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.
19302 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
19303 represents complete breast removal. This code is for breast-conserving excision with axillary lymphadenectomy.
No office rate
19307 describes modified radical mastectomy, involving more extensive breast removal along with axillary dissection; this code preserves part of the breast.
Compare 19302 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
Iowa →
Office / nonfacility
Unavailable
Facility
$771.69
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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 19302 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
1,687
- Code
- 19302
- Physician work
- 13.64
- Practice expense
- 8.82
- Malpractice
- 3.51
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.64 | × 1.000 | 13.6400 |
| Practice expense | 8.82 | × 0.915 | 8.0703 |
| Malpractice | 3.51 | × 0.397 | 1.3935 |
| Total RVUs | 23.1038 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$771.69
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.64 | 1 |
| Practice expense | 8.82 | 0.915 |
| Malpractice | 3.51 | 0.397 |
(13.64 × 1 + 8.82 × 0.915 + 3.51 × 0.397) × $33.4009 = $771.69
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.
19302 billing questions
When should this code be chosen instead of 19301?
Use 19302 when the operation includes both partial breast removal and axillary lymphadenectomy. For partial breast removal without that axillary dissection, consider 19301.
Does sentinel node biopsy support reporting 19302?
Sentinel node evaluation alone is not axillary lymphadenectomy. If the surgeon performs only sentinel node biopsy with partial mastectomy, 19302 is not the appropriate code for the breast procedure.
How is bilateral surgery reported under the CMS facts?
For bilateral procedures, modifier 50 is paid at 150% under the CMS payment rule supplied for this code.
What postoperative care is included in the global period?
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?
An assistant at surgery may be paid. Co-surgeons are paid only with 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.
1,68419298,,Place breast rad tube/caths,A,,5.61,19.44,,1.84,,0.44,25.49,7.89,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,68519300,,Mastectomy for gynecomastia,A,,5.18,12.69,,6.36,,1.21,19.08,12.75,0,090,0.10,0.71,0.19,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,68619301,,Partial mastectomy,A,,9.88,6.52,NA,6.52,,2.54,18.94,18.94,0,090,0.10,0.71,0.19,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,68719302,,P-mastectomy w/ln removal,A,,13.64,8.82,NA,8.82,,3.51,25.97,25.97,0,090,0.10,0.71,0.19,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,68819303,,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
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136