Billing code 19307: MastectomyMedicare rate & RVUs in Virginia
Reports breast removal for cancer with axillary lymph node dissection, typically when the operation includes both breast tissue and regional nodal surgery.
CMS doesn’t publish an office rate for 19307 in Virginia.
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 19307 covers
A surgeon removes breast tissue and performs an axillary lymph node dissection, usually as treatment for breast cancer. The procedure is generally performed in a hospital operating room. The modified radical approach removes the breast and axillary nodes while preserving the pectoral muscles; the nodal dissection is part of this operation, not a separate service for the same work.
Report the code when the operative record supports both breast removal and axillary node dissection, rather than a simple mastectomy or partial breast removal. Document the side and the extent of the operation. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during the 90 days after surgery. For bilateral surgery, modifier 50 is paid at 150%. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. An assistant at surgery may be paid; 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 19307 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | Unavailable | $1,244.67 |
| Virginia | Unavailable | $1,075.51 |
How the 19307 rate is calculated
Each of 19307’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 · 19307
RVUs × geographic indexes × conversion factor
Work17.54
17.54 RVUs× 1.000 GPCI
Practice expense11.66
11.66 RVUs× 1.000 GPCI
Malpractice4.53
4.53 RVUs× 1.000 GPCI
Adjusted RVUs
33.7300
Conversion factor
$33.4009
Medicare rate
$1,126.61
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 19307
19307 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 19307
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 · 19307
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
19307 without 50 · national facility
$1,126.61
Mastectomy
19307-50 · Bilateral: 150%
$1,689.91
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).
19307 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 19302Partial mastectomy
- Use 19302 when breast-conserving surgery is performed with axillary node dissection. Use 19307 when the breast is removed with the nodal dissection.
- 19303Mastectomy
- 19303 describes breast removal without the axillary node dissection included in 19307. The operative report should establish whether nodal dissection was performed.
- 19305Mastectomy
- 19305 is for a radical operation that includes removal of pectoral muscles. 19307 describes the modified radical approach, which preserves them.
- 19306Radical mastectomy
- 19306 identifies the Urban-type radical operation, a distinct, more extensive radical approach. Use 19307 for the modified radical operation with axillary dissection.
19307 billing questions
How does this differ from a simple mastectomy?
This code includes axillary lymph node dissection along with breast removal. A simple mastectomy does not include that nodal operation.
Can the axillary dissection be reported separately?
The axillary lymph node dissection is included in this operation. Do not separately report the same nodal work as though it were a separate procedure.
What supports reporting this code instead of partial mastectomy with node removal?
The operative report should show removal of the breast, not breast-conserving excision, together with axillary lymph node dissection.
How is bilateral surgery reported?
Use modifier 50 for bilateral surgery. CMS pays bilateral procedures at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days after surgery.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. 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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