CPT 19307 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 19307 |
National average reimbursement for CPT 19307 by major payers:

$1,567.49

$1,528.91

$1,589.54

$1,947.08
| 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 19307 | ||||||
United | 19307 | $3100.00 | 1285282343 - DEERBROOK SURGERY CENTER LLC, KINGWOOD ENDOSCOPY | 813375333 - (TX) DEERBROOK SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19307 | $2718.00 | 1568864452 - CARPUS SURGERY CENTER LLC | 471128977 - (GA) CARPUS SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19307 | $1308.00 | 1295798346 - SUNRISE FLAMINGO SURGERY CENTER, LLC, FLAMINGO SURGERY CENTER | 621679326 - (NV) SUNRISE FLAMINGO SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19307 | $627.00 | 1124092945 - ROCKLEDGE FL ENDOSCOPY ASC LLC, SPACE COAST ENDOSCOPY CENTER | 200073131 - (FL) ROCKLEDGE FL ENDOSCOPY ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19307 | $816.00 | 1780658062 - GLEN ENDOSCOPY CENTER, LLC | 364486546 - (IL) THE GLEN ENDOSCOPY CENTER, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19307 | $947.78 | 1225394398 - INGER REYNOLDS | 350593390 - DEACONESS HOSPITAL INC | TN | Certified Registered Nurse Anesthetist (367500000X) |
United | 19307 | $899.00 | 1043216617 - TRIAD SURGERY CENTER LLC, TRIAD EYE MEDICAL CLINIC AND CATARACT INSTITUTE PLLC | 465002052 - (OK) TRIAD EYE INSTITUTE, PLLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19307 | $2000.00 | 1588994685 - SOUTHEASTERN INTERVENTIONAL PAIN ASC LLC | 271651377 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19307 | $5589.00 | 1497749436 - NEW JERSEY SURGERY CENTER LLC, NEW JERSEY SURGERY CENTER | 161666417 - (NJ) NEW JERSEY SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19307 | $7770.00 | 1396175246 - MEMORIAL HERMANN BAY AREA ENDOSCOPY CENTER, LLC, BAY AREA ENDOSCOPY | 364773048 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19307 | $947.78 | 1518561687 - KARI CLARIDGE | 350593390 - DEACONESS HOSPITAL INC | IN | Medical Physician Assistant (363AM0700X) |
United | 19307 | $2530.00 | 1124283510 - WILLS EYE SURGERY CENTER | 510385184 - (DE) WILMINGTON AMBULATORY SURGICAL CENTER LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19307 | $947.78 | 1164469722 - TERRY HOFF | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 19307 | $1700.00 | 1407227358 - BAPTIST SURGERY AND ENDOSCOPY CENTERS LLC, BAPTIST HEALTH SURGERY CENTER AT NORTHPOINT | 650592518 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19307 | $8387.00 | 1982871935 - NORTHERN VIRGINIA SURGERY CENTER LLC | 203502477 - (VA) NORTHERN VIRGINIA SURGERY CENTER LLC | VA | 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 19307 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19307 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 19307 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 |
|---|---|---|
| 19301-CPT | Moderate | Mastectomy, Partial (E.G. Lumpectomy, Tylectomy, Quandrantectomy, Segmentectomy) |
| 19302-CPT | High | With Axillary Lymphadenectomy |
| 19303-CPT | High | Mastectomy Simple Complete |
| 19307-CPT | High | 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 19307. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19307 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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