Billing code 19305: MastectomyMedicare rate & RVUs in Oregon
Reports removal of the breast, pectoral muscles, and axillary lymph nodes in a radical operation for extensive breast cancer.
CMS doesn’t publish an office rate for 19305 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 19305 covers
This operation removes the breast together with the pectoral muscles and axillary lymph nodes. It is an uncommon, extensive approach for breast cancer and is typically performed by a breast or surgical oncologist in a hospital operating room. The operative report should identify the structures removed and the extent of the axillary dissection; the documented procedure, rather than the cancer diagnosis alone, supports selection of this code.
Report the code when the operation includes the full radical extent, not for a mastectomy that preserves the pectoral muscles or removes only part of the breast. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; 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 19305 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $1,110.45 |
| Rest Of Oregon | Unavailable | $1,051.48 |
How the 19305 rate is calculated
Each of 19305’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 · 19305
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 17.02Practice expense 11.42Malpractice 4.39
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 19305
19305 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 19305
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 · 19305
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
19305 without 50 · national facility
$1,096.55
Mastectomy
19305-50 · Bilateral: 150%
$1,644.83
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).
19305 compared with similar codes
Compare codes
19305 vs 19307 vs 19306 vs 19303 vs 19302: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 19307Mastectomy
- Use the modified radical code when the breast and axillary nodes are removed but the pectoral muscles are preserved. This code represents removal of those muscles as well.
- 19306Radical mastectomy
- The extended radical variant includes internal mammary lymph node removal in addition to the radical mastectomy extent.
- 19303Mastectomy
- A complete mastectomy without the radical removal of pectoral muscles and axillary lymph nodes is reported with this code.
- 19302Partial mastectomy
- This code represents partial breast removal with axillary lymph node removal, rather than removal of the entire breast and pectoral muscles.
19305 billing questions
How does this differ from a modified radical mastectomy?
This code includes removal of the pectoral muscles along with the breast and axillary lymph nodes. The modified radical procedure preserves the pectoral muscles.
Does this code include axillary lymph node removal?
Yes. Axillary lymph node removal is part of the radical operation represented by this code.
Can breast reconstruction be reported with this mastectomy?
Immediate reconstruction may be performed in the same session and reported separately when supported by the documented reconstructive service. For example, tissue expander placement may accompany mastectomy.
How is bilateral surgery reported?
CMS identifies this as a bilateral procedure; reporting modifier 50 is paid at 150%.
What postoperative care is included?
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?
Assistant-at-surgery payment may be available. 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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