Billing code 19300: Gynecomastia surgeryMedicare rate & RVUs in Washington
Surgical removal of breast tissue for gynecomastia, typically performed to reduce glandular enlargement and improve chest contour.
Medicare pays $652.34–$734.76 for 19300 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). Which amount applies depends on the service address.
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 19300 covers
This operation removes breast tissue to treat gynecomastia, or enlargement of male breast tissue. A general or plastic surgeon may perform it in a hospital outpatient department or ambulatory surgery center, with the operative approach guided by the tissue and contour findings. The service is distinct from breast surgery for a tumor and from reduction surgery for generalized breast hypertrophy.
Report 19300 when the operation addresses gynecomastia; the operative report should support the diagnosis and describe the tissue removal performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For bilateral surgery reported with modifier 50, CMS pays at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. CMS does not pay an assistant at surgery, and 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 19300 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $652.34 | $429.71 |
| Seattle (King Cnty) | $734.76 | $475.34 |
How the 19300 rate is calculated
Each of 19300’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 · 19300
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.18Practice expense 12.69Malpractice 1.21
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 19300
19300 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 19300
Gynecomastia surgery
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 19300
Gynecomastia surgery
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
19300 without 50 · national office
$637.29
Gynecomastia surgery
19300-50 · Bilateral: 150%
$955.94
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).
19300 compared with similar codes
Compare codes
19300 vs 19318 vs 19303 vs 19301: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 19318Breast reduction
- Choose 19300 for surgery addressing gynecomastia; 19318 is for breast reduction surgery for hypertrophy.
- 19303Mastectomy
- 19303 describes complete breast removal for a different indication. It is not the gynecomastia-specific procedure.
- 19301Partial mastectomy
- 19301 is partial mastectomy for a lesion-directed breast operation, not removal of tissue to treat gynecomastia.
19300 billing questions
How is 19300 different from breast reduction code 19318?
19300 is for surgery addressing gynecomastia. Code 19318 describes reduction surgery for breast hypertrophy, so the documented condition and operation guide the choice.
How should bilateral gynecomastia surgery be reported?
Report modifier 50 for bilateral surgery. CMS pays the bilateral procedure at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant surgeon or co-surgeon be paid?
CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, CMS pays the highest-valued procedure in full and pays other procedures at 50%.
What documentation supports reporting 19300?
Document gynecomastia as the condition treated and describe the breast tissue removal performed. The operative report should make clear that the surgery addressed gynecomastia rather than a tumor or generalized breast hypertrophy.
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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