Billing code 19294: IORT cavity prepMedicare rate & RVUs in Oregon
Reports preparation of a breast tumor cavity and placement of an intraoperative radiation applicator following partial mastectomy.
CMS doesn’t publish an office rate for 19294 in Oregon.
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 19294 covers
During breast-conserving surgery, the surgeon prepares the excision cavity and positions an applicator so radiation can be delivered intraoperatively. The service is performed in the operating room after removal of the breast lesion; the applicator is placed in the resulting tumor bed for the planned intraoperative treatment. Radiation delivery itself is a distinct service, commonly performed by a radiation oncologist with the surgical team present.
Report 19294 as an add-on with the primary partial mastectomy procedure, not as a stand-alone service. The operative report should support the partial mastectomy, preparation of the cavity, and placement of the applicator for intraoperative radiation. CMS treats this as an add-on paid within the primary procedure’s global period. The code represents cavity preparation and applicator placement, not the radiation dose or delivery.
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 19294 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $145.78 |
| Rest Of Oregon | Unavailable | $140.33 |
How the 19294 rate is calculated
Each of 19294’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 · 19294
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.93Practice expense 0.74Malpractice 0.76
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 19294
The CMS indicators that decide how 19294 is paid alongside other services.
CMS payment indicators · 19294
IORT cavity prep
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
19294 compared with similar codes
Compare codes
19294 vs 19301 vs 19296 vs 19297 vs 77424: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 19301Partial mastectomy
- 19301 reports the partial mastectomy itself. Use 19294 as an add-on when the tumor cavity is prepared and an applicator is placed for intraoperative radiation.
- 19296Breast catheter placement
- 19296 concerns breast catheter placement for a radiation approach using a catheter after partial mastectomy; 19294 is for an applicator placed for treatment during surgery.
- 19297Radiation applicator
- 19297 also concerns breast catheter placement for radiation after partial mastectomy. It is not the cavity-preparation and intraoperative-applicator service described by 19294.
- 77424Io rad tx delivery by x-ray
- 77424 represents electron intraoperative radiation delivery. 19294 reports the surgical preparation and applicator placement, not the radiation treatment.
19294 billing questions
Can 19294 be reported by itself?
No. It is an add-on code and must be billed with an eligible primary procedure, typically the partial mastectomy.
How does 19294 differ from 19301?
19301 reports the partial mastectomy. 19294 reports the additional work of preparing the tumor cavity and placing the applicator for intraoperative radiation.
Does 19294 include radiation delivery?
No. It covers cavity preparation and applicator placement; radiation delivery is a distinct service, such as the treatment represented by 77424 or 77425.
What documentation supports 19294?
The operative report should describe the partial mastectomy, preparation of the tumor bed, and placement of the applicator for intraoperative radiation.
How does the global-period rule affect reporting?
CMS pays this add-on within the primary procedure’s global period. It must be reported with the primary procedure rather than as a separate stand-alone service.
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
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