No office rate
Both are radical mastectomy procedures involving pectoral muscles and axillary nodes. This code also includes internal mammary node removal.
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CMS RVU26D · Effective 2026-10-01
19306 Radical mastectomy Medicare reimbursement rates in Washington
Reports an Urban-type radical mastectomy removing the breast, pectoral muscles, axillary nodes, and internal mammary nodes during extensive breast cancer surgery. Compare 19306 office and facility rates across CMS payment localities in Washington.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 19306 in Washington?
Washington has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1169.68–$1274.94
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Breast surgery
About 19306: Urban-type radical mastectomy
Reports an Urban-type radical mastectomy removing the breast, pectoral muscles, axillary nodes, and internal mammary nodes during extensive breast cancer surgery.
This operation removes the breast along with the pectoral muscles and lymph nodes in both the axilla and internal mammary chain. It is an extensive breast cancer procedure typically performed by a breast surgeon or surgical oncologist in an operating room. The internal mammary node dissection distinguishes this Urban-type operation from other radical mastectomy approaches.
Report the procedure when the operative record supports removal of all these structures; the included nodal work is part of the operation, not a separate service for the same dissection. Documentation should identify the breast and specify removal of the pectoral muscles, axillary nodes, and internal mammary nodes. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 19306
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU17.68 · 50%
- Practice expense (office) RVU12.83 · 36%
- Malpractice RVU4.73 · 13%
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.
19306 compared with similar codes
Office rates for Washington, from the same CMS release.
No office rate
The modified radical procedure preserves the pectoralis major muscle. This Urban-type procedure includes pectoral muscle removal and internal mammary node dissection.
No office rate
Code 19303 describes complete breast removal without the pectoral muscle and nodal extent of this Urban-type operation.
Compare 19306 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Rest Of Washington →
Office / nonfacility
Unavailable
Facility
$1169.68
Seattle (King Cnty) →
Office / nonfacility
Unavailable
Facility
$1274.94
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19306 billing questions
How is this different from code 19305?
This Urban-type operation includes internal mammary node removal in addition to the breast, pectoral muscles, and axillary nodes. Code 19305 describes a radical mastectomy without that internal mammary node component.
How is this different from a modified radical mastectomy?
Code 19307 preserves the pectoralis major muscle and does not describe the internal mammary node dissection included in this operation. Use the operative details to distinguish the procedures.
Can the axillary or internal mammary node dissection be reported separately?
The node removal is included in this operation when performed as part of the mastectomy. Do not separately report the same dissection as an additional service.
What does the 90-day global period include?
It includes the day-before preoperative visit and 90 days of related postoperative care. CMS treats this as major surgery.
How should bilateral procedures be reported?
CMS specifies bilateral reporting with modifier 50, paid at 150%. The operative documentation should support that the procedure was performed on both breasts.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,68719302,,P-mastectomy w/ln removal,A,,13.64,8.82,NA,8.82,,3.51,25.97,25.97,0,090,0.10,0.71,0.19,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,68819303,,Mast simple complete,A,,14.63,9.04,NA,9.04,,3.75,27.42,27.42,0,090,0.10,0.71,0.19,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,68919305,,Mast radical,A,,17.02,11.42,NA,11.42,,4.39,32.83,32.83,0,090,0.10,0.71,0.19,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,69019306,,Mast rad urban type,A,,17.68,12.83,NA,12.83,,4.73,35.24,35.24,0,090,0.10,0.71,0.19,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,69119307,,Mast mod rad,A,,17.54,11.66,NA,11.66,,4.53,33.73,33.73,0,090,0.10,0.71,0.19,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,69219316,,Mastopexy,A,,10.81,8.89,NA,8.89,,2.13,21.83,21.83,0,090,0.10,0.71,0.19,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,69319318,,Breast reduction,A,,15.63,10.76,NA,10.76,,2.96,29.35,29.35,0,090,0.10,0.71,0.19,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00