CPT 19305 Fee Schedule
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.
| 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 |
National average reimbursement for CPT 19305 by major payers:
$1,494.43
$1,449.84
$1,449.40
$1,875.99
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 19305 | ||||||
United | 19305 | $1019.00 | 1346207875 - GREENSBORO SPECIALTY SURGERY CENTER LIMITED PARTNERSHIP | 364053840 - (NC) GREENSBORO SPECIALTY SURGERY CENTER LIMITED PARTNERSHIP | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19305 | $1028.00 | 1588610190 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19305 | $583.00 | 1962580266 - NOVAMED SURGERY CENTER OF WARRENSBURG LLC, EYE SURGERY CENTER OF WARRENSBURG | 205698307 - (MO) NOVAMED SURGERY CENTER OF WARRENSBURG LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19305 | $785.00 | 1437250248 - GEORGIA SURGICAL CENTER ON PEACHTREE, LLC | 582394271 - (GA) GEORGIA SURGICAL CENTER ON PEACHTREE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19305 | $470.00 | 1497740872 - SHASTA EYE SURGEONS INC, SURGERY CENTER OF NORTHERN CALIFORNIA | 205757123 - (CA) SHASTA EYE SURGEONS INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19305 | $1492.00 | 1457379158 - HUDSON CROSSING SURGERY CENTER, LLC, HUDSON CROSSING SURGERY CENTER | 364533553 - (NJ) HUDSON CROSSING SURGICAL CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19305 | $743.00 | 1477886406 - BILTMORE SURGICAL PARTNERS, LLC, DEER VALLEY SURGICAL AND ENDOSCOPY CENTER | 264509307 - (AZ) BILTMORE SURGICAL PARTNERS LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19305 | $524.00 | 1073818654 - ROYAL OAK SURGICAL CENTER, LLC, ROYAL OAK SURGICAL CENTER PLLC | 320323562 - (MI) ROYAL OAK SURGICAL CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19305 | $1020.00 | 1154034429 - CROSSINGS SURGERY CENTER, LLC | 472361569 - (RI) ORTHOPEDICS RHODE ISLAND, INC. | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19305 | $712.00 | 1376546721 - DULANEY EYE INSTITUTE, LLC | 521886840 - (MD) DULANEY EYE INSTITUTE LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19305 | $709.00 | 1295738375 - OREGON SURGICENTER LLC | 431980819 - (OR) OREGON SURGICENTER, LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19305 | $5554.00 | 1124492541 - MEMORIAL HERMANN SURGERY CENTER PINECROFT, LLC | 371796296 - (TX) MEMORIAL HERMANN SURGERY CENTER PINECROFT LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19305 | $1200.00 | 1285936641 - RIVERS EDGE AESTHETIC SURGERY, LLC | 271645468 - (SD) RIVERS EDGE AESTHETIC SURGERY LLC | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19305 | $1028.00 | 1588260343 - ADVENTHEALTH SURGERY CENTER WELLSWOOD LLC, ADVENTHEALTH SURGERY CENTER WELLSWOOD | 854111089 - (FL) ADVENTHEALTH SURGERY CENTER WELLSWOOD LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19305 | $689.00 | 1346396082 - PARKWAY SURGICAL CENTER, LLC | 911613809 - (WA) PARKWAY SURGICAL CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 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 |
|---|---|---|
| 19297-CPT | Low | Placement Of Radiotherapy Afterloading Expandable Catheter (Single Or Multichannel) Into The Breast For Interstitial Radioelement Application Following Partial Mastectomy, Includes Imaging Guidance; Concurrent With Partial Mastectomy (List Separately In Addition To |
| 19302-CPT | High | With Axillary Lymphadenectomy |
| 19303-CPT | High | Mastectomy Simple Complete |
| 19305-CPT | High | Mastectomy Radical Including Pectoral Muscles Axillary 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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