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See a sample rate comparisonCPT 19305 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Mastectomy (Breast Removal), Surgery To Remove A Breast (Mastectomy). A Radical Mastectomy Additionally Removes Surrounding Muscle Tissue And Nearby Lymph Nodes.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 19305 |
| Medicaid Fee Schedule | View Medicaid rates for 19305 |
National average reimbursement for CPT 19305 by major payers:
$1,494.43
$1,449.84
$1,449.40
$1,832.73
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CPT 19305
5 of 25 sample ratesHigher to lower in this preview
Peak One Surgery Center, LLC, Peak One Surgery Center
Peak One Surgery Center LLC
$9,210.00Published rateSummit Ambulatory Surgical Center, LLC
$1,028.00Published rateGeorgia Surgical Center On Peachtree, LLC
Georgia Surgical Center On Peachtree LLC
$785.00Published rateNovamed Surgery Center Of Warrensburg LLC, Eye Surgery Center Of Warrensburg
Novamed Surgery Center Of Warrensburg LLC
$583.00Published rateSouth Pointe Surgical Center
South Pointe Surgical Center, LLC
$200.00Published rate
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See a sample payer proposalCPT 19305 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19305 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 19305 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 19302-CPT | High | Removal Of Part Of A Breast, Surgery To Remove A Single Lump Or A Portion Of The Breast Tissue (Partial Mastectomy). Nearby Lymph Nodes Also May Be Removed. |
| 19303-CPT | High | Mastectomy (Breast Removal), Surgery To Remove A Breast (Mastectomy). A Radical Mastectomy Additionally Removes Surrounding Muscle Tissue And Nearby Lymph Nodes. |
| 19305-CPT | High | Mastectomy (Breast Removal), Surgery To Remove A Breast (Mastectomy). A Radical Mastectomy Additionally Removes Surrounding Muscle Tissue And Nearby Lymph Nodes. |
| 19306-CPT | High | Mastectomy (Breast Removal), Surgery To Remove A Breast (Mastectomy). A Radical Mastectomy Additionally Removes Surrounding Muscle Tissue And Nearby Lymph Nodes. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 19305. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19305 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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