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CPT 19300: Excision of Male Breast for Gynecomastia
Headline: CPT code 19300: Surgical Excision for Gynecomastia
CPT code 19300 denotes excision of the male breast for treatment of gynecomastia, a procedure that addresses symptomatic or cosmetic breast enlargement in men. Nationally, this code captures surgical management by plastic and reconstructive surgeons and related specialists and is relevant for coverage determinations, utilization monitoring, and quality measurement for benign breast conditions. Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare.
Readers will find clinical and billing context for use of CPT code 19300, including typical service settings and its relationship to other breast surgery codes. The summary covers how the code is positioned relative to partial and simple mastectomy codes, common diagnostic pairings, and expected provider specialties. The publication also highlights payer coverage patterns and benchmarking considerations used by national payers and Medicare for surgical management of gynecomastia.
This material provides a concise reference for coding teams, surgical practices, and policy analysts seeking an overview of CPT code 19300, its clinical intent, and the payer landscape that governs payment and authorization practices.
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Billing Code Overview
CPT code 19300 describes surgical excision of the male breast to treat excessive enlargement (gynecomastia). This procedure is a gynecomastia excision performed to remove glandular and/or fatty breast tissue in male patients.
Service type: Surgical procedure — plastic/reconstructive surgery
Typical site of service: Hospital operating room or ambulatory surgical center
National Reimbursement Benchmarks
Commercial averages run well above Medicare for CPT 19300: Blue Cross Blue Shield and BUCA exhibit notably higher means versus Medicare’s mean of $656.7. BUCA’s mean is $1,922 and Blue Cross Blue Shield’s mean is $2,833.50, creating a clear gap between Medicare and higher-tier commercial payers. UnitedHealth Group, Cigna, and Aetna occupy intermediate positions with means of $831.20, $803.60, and $485 respectively.
Dispersion varies considerably by payer. Blue Cross Blue Shield shows the widest interquartile spread (P75–P25 = $2,822.00), followed by UnitedHealth Group (P75–P25 = $549.60) and BUCA (P75–P25 = $1,782.30). The tightest IQR is Aetna at $174.40, with Cigna slightly wider at $473.90. Medicare’s reported P25–P75 spread is $71.00, indicating the most compressed distribution among those listed.