Billing code 19301: Partial mastectomyMedicare rate & RVUs in Oregon
Report 19301 for breast-conserving surgery that removes a breast lesion with surrounding tissue, commonly for cancer or ductal carcinoma in situ.
CMS doesn’t publish an office rate for 19301 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 19301 covers
A breast surgeon removes a lesion and a surrounding portion of breast tissue while preserving the remainder of the breast. This is commonly performed for breast cancer or ductal carcinoma in situ, in a hospital or ambulatory surgical setting. The operative report should identify the breast and site, the lesion being treated, and the extent of tissue removed. Axillary node surgery is a separate part of the operation when performed and may be reported with an appropriate node procedure code.
Select 19301 when the operation is a partial mastectomy, rather than a simple complete mastectomy or an excision reported as a breast lesion excision. The 90-day global period includes the day-before preoperative visit and related postoperative care through day 90. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are 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 19301 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $640.35 |
| Rest Of Oregon | Unavailable | $606.54 |
How the 19301 rate is calculated
Each of 19301’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 · 19301
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 9.88Practice expense 6.52Malpractice 2.54
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 19301
19301 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 19301
Partial 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) | 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. |
| 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 · 19301
Partial 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
19301 without 50 · national facility
$632.61
Partial mastectomy
19301-50 · Bilateral: 150%
$948.92
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).
19301 compared with similar codes
Compare codes
19301 vs 19302 vs 19303 vs 19120 vs 19307: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 19302Partial mastectomy
- Choose 19302 when axillary lymphadenectomy is part of the partial mastectomy; 19301 describes the breast-conserving resection without that added operation.
- 19303Mastectomy
- 19303 is for complete removal of the breast; 19301 preserves breast tissue by removing a portion.
- 19120Breast lesion excision
- 19301 represents a partial mastectomy, commonly an oncologic breast-conserving operation with surrounding tissue removed. 19120 is used for breast lesion excision when the procedure is not a partial mastectomy.
- 19307Mastectomy
- 19307 describes a modified radical mastectomy. It is distinct from the breast-conserving resection reported with 19301.
19301 billing questions
How does 19301 differ from 19302?
19301 describes breast-conserving partial mastectomy. Use 19302 when the operation also includes axillary lymphadenectomy.
Can sentinel node surgery be reported with 19301?
Yes, when a distinct sentinel lymph node procedure is performed during the encounter. The operative documentation should support the node procedure as well as the breast resection.
When is 19303 a better choice?
Use 19303 for a simple complete mastectomy, rather than an operation that preserves part of the breast.
How is bilateral 19301 reported?
CMS lists bilateral reporting with modifier 50 and payment at 150%. The operative record should support surgery on both breasts.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care through day 90.
What supports assistant-at-surgery payment?
Documentation must establish the medical necessity of the assistant at surgery.
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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