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See a sample rate comparisonCPT 19306 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 19306 |
| Medicaid Fee Schedule | View Medicaid rates for 19306 |
National average reimbursement for CPT 19306 by major payers:
$1,544.19
$1,533.26
$1,520.69
$1,946.52
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CPT 19306
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Kirby, LLC, Memorial Hermann Surgery Center Kirby Glen
$4,893.00Published rateDelaware River Surgical Suites, LLC
Bucks County Surgical Suites
$1,064.00Published ratePearland Surgery Center, LLC
$760.00Published rateSoutheast Eye Laser Surgery Center
$553.00Published rateSurgery Center Of Lynchburg LLC
$128.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 19306 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19306 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 19306 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 |
|---|---|---|
| 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. |
| 19307-CPT | High | Mastectomy Modified Radical, Mastectomy Modified Radical Including Axillary Lymph Nodes With Or Without Pectoralis Minor Muscle But Excluding Pectoralis Major Muscle |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 19306. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19306 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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