CPT 19302: Breast-Conserving Surgery with Axillary Lymph Node Removal

CPT code 19302 represents a breast-conserving surgical procedure in which a lesion or a substantial portion of the breast (segment or quadrant) is excised along with axillary lymph node removal. This code is central to surgical management of breast malignancy and high-risk breast lesions because it combines tumor excision with regional nodal assessment or clearance, affecting staging, adjuvant therapy decisions, and quality measures.

Key national payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find benchmarking context on utilization patterns and reimbursement considerations, clinical context linking the procedure to oncologic care pathways, and coding relationships to related breast and axillary procedures. The publication outlines typical sites of service and the clinical rationale for combining breast-conserving surgery with axillary node procedures.

This summary provides a national perspective for clinicians, coding professionals, and policy analysts on how CPT code 19302 is used in practice, where it fits among related mastectomy and lymph node procedure codes, and what operational elements—such as site of service and clinical indications—are commonly associated with claims using this code.

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Billing Code Overview

CPT code 19302 describes the surgical removal of a breast lesion, including surrounding margins, or removal of a significant portion of the breast (such as a segment or quadrant), performed together with removal of axillary lymph nodes. This procedure is a breast-conserving surgery with axillary lymph node removal intended to treat malignant or high-risk lesions while addressing regional nodal disease.

Service type: Surgical, oncologic breast procedure

Typical site of service: Hospital operating room or ambulatory surgical center

National Reimbursement Benchmarks

Commercial averages sit well above Medicare for CPT 19302: Blue Cross Blue Shield, Cigna, Aetna, UnitedHealth Group and BUCA all report mean rates higher than Medicare’s mean of $877.10. BUCA’s mean commercial rate is $3,407.00, roughly $2,529.90 higher than Medicare, highlighting a substantial commercial-versus-Medicare gap for this code.

Dispersion (P75 minus P25) varies notably by payer. Blue Cross Blue Shield shows the widest interquartile spread at $5,036.60 (P75 $6,815.70 minus P25 $1,779.10), indicating greater variability in commercial negotiated rates. Aetna and UnitedHealth Group have tighter spreads of $410.00 and $551.20 respectively, while Cigna’s spread is $1,071.10. BUCA’s interquartile range is $3,226.70, larger than several payers but smaller than BCBS, and Medicare’s IQR is narrow at $71.00 (P75 $912 minus P25 $841).

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CPT 19302: Breast-Conserving Surgery with Axillary Lymph Node Removal

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Billing Code Overview

Service type: Surgical, oncologic breast procedure

Typical site of service: Hospital operating room or ambulatory surgical center

National Reimbursement Benchmarks

National Payer Mean Reimbursement Rates

Clinical & Coding Specifications

Clinical Context

A 54-year-old female presents with a palpable mass in the upper outer quadrant of the right breast and a core needle biopsy confirming invasive ductal carcinoma. Imaging shows a localized lesion without distant metastasis. The surgical plan is a partial mastectomy (segmental resection/quadrantectomy) with removal of regional axillary lymph nodes for staging and local control. Preoperative workflow includes history and physical, imaging review (mammography/ultrasound, possible MRI), biopsy pathology, pre-op clearance, and sentinel lymph node mapping in the operating room. Intraoperatively, the surgeon performs a resection of the lesion with surrounding margins (segment or quadrant) and performs sentinel lymph node biopsy or targeted axillary node excision; specimens are sent for pathology and, if needed, frozen section. Postoperative workflow includes recovery, pathology review for margin status and nodal involvement, coordination with Medical Oncology and Radiation Oncology for adjuvant therapy decisions, and documentation of laterality and any modifiers (for example LT/RT for laterality or 22 for increased procedural service) in the operative note and claim submission.

Coding Specifications

Modifier	Description	When to Use
`LT`	Left side	Use to indicate the procedure was performed on the left breast.
`RT`	Right side	Use to indicate the procedure was performed on the right breast.
`22`	Increased procedural services	Use when the operative report documents substantially greater work than typical for a partial mastectomy with axillary node removal (requires supporting documentation).
`59`	Distinct procedural service	Use when a separate, distinct procedure is performed at the same operative session that is not typically bundled.
`26`	Professional component	Use when billing separates the physician (professional) component from the technical component of a service.
`52`	Reduced services	Use when the service was partially reduced or not completed as described by the full CPT code.
`53`	Discontinued procedure	Use when the procedure was started but terminated for clinical reasons prior to completion.
`62`	Two surgeons	Use when two surgeons from different specialties work together as primary surgeons.
`80`	Assistant surgeon	Use when an assistant surgeon is involved and paid separately.
`51`	Multiple procedures	Use when multiple additional procedures are billed during the same operative session.
`QY`	Service furnished in part by a PA	Use when a physician assistant performs portions of the service under physician direction and billing requires this identification.
`QX`	Service performed by assistant qualified under NPP rules	Use when an assistant at surgery meets state/supervision requirements and is billed accordingly.
`QK`	Anesthesia-directed CRNA	Use when a CRNA provides anesthesia under an anesthesiologist-directed model (as applicable to facility billing alignment).
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist in postoperative critical care	Use when advanced practice clinicians provide critical care services related to the operative admission (if applicable).

Taxonomy Code	Specialty	Notes
`208600000X`	Surgery Physician	General surgeons performing breast-conserving resections and axillary node procedures.
`207RH0003X`	Surgical Oncology Physician	Surgeons specializing in oncologic breast surgery and complex axillary management.
`207N00000X`	Dermatology Physician	Occasionally involved for skin-sparing approaches or local lesion management when skin excision is required.
`207RG0100X`	Gastroenterology Physician	Data provided; not commonly performing this procedure but listed in associated taxonomies.
`207RI0200X`	Vascular Surgery Physician	Data provided; not typically performing breast resections but listed in associated taxonomies.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C50.911`	Malignant neoplasm of unspecified site of right female breast	Primary malignant diagnosis prompting partial mastectomy with axillary staging on the right side.
`C50.912`	Malignant neoplasm of unspecified site of left female breast	Primary malignant diagnosis prompting partial mastectomy with axillary staging on the left side.
`D05.11`	Lobular carcinoma in situ of right breast	In situ lesion that may prompt excisional management or influence surgical planning on the right.
`D05.12`	Lobular carcinoma in situ of left breast	In situ lesion that may prompt excisional management or influence surgical planning on the left.
`Z85.3`	Personal history of malignant neoplasm of breast	Relevant for surveillance, reconstruction planning, or contralateral procedures in patients with prior breast cancer.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`19301`	Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy)	Alternative CPT for breast-conserving surgery; `19302` differs by explicit inclusion of axillary lymph node removal.
`19307`	Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding pectoralis major muscle	More extensive procedure when full mastectomy with axillary dissection is required instead of a segmental resection.
`38500`	Biopsy or excision of lymph node(s); open, superficial	May be used for isolated superficial nodal biopsies separate from the primary breast resection.
`38525`	Biopsy or excision of lymph node(s); open, deep axillary node(s)	Used when a discrete deep axillary node excision is performed in addition to or instead of sentinel node techniques.
`38745`	Axillary lymphadenectomy; complete	Used for a full axillary dissection when multiple level node removal is required beyond sentinel or targeted node biopsy.
`38900`	Intraoperative identification (eg, mapping) of sentinel lymph node(s) includes injection of non-radioactive dye, when performed (List separately in addition to code for primary procedure)	Billed in addition to `19302` when sentinel node mapping/identification is performed during the same operative session.

CPT 19300: Excision of Male Breast for Gynecomastia

CPT-19301-PARTIAL-MASTECTOMY-BREAST-LESION-EXCISION

CPT 19301: Partial Mastectomy / Excision of Breast Lesion

CPT-19303-SIMPLE-MASTECTOMY-BREAST-REMOVAL

CPT 19303: Simple Mastectomy, Removal of Breast and Nipple–Areolar Complex

CPT-19305-RADICAL-MASTECTOMY-CHEST-WALL-AND-AXILLARY-LYMPH-NODES

CPT 19305: Radical Mastectomy with Chest Wall and Axillary Lymph Node Removal

CPT-19306-RADICAL-MASTECTOMY-TOTAL-CHEST-WALL-AND-LYMPHADENECTOMY

CPT 19306: Radical Mastectomy with Chest Wall and Lymphadenectomy

CPT-19307-MASTECTOMY-REMOVAL-ENTIRE-BREAST

CPT 19307: Mastectomy, Removal of Entire Breast

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`LT`	Left side	Use to indicate the procedure was performed on the left breast.
`RT`	Right side	Use to indicate the procedure was performed on the right breast.
`22`	Increased procedural services	Use when the operative report documents substantially greater work than typical for a partial mastectomy with axillary node removal (requires supporting documentation).
`59`	Distinct procedural service	Use when a separate, distinct procedure is performed at the same operative session that is not typically bundled.
`26`	Professional component	Use when billing separates the physician (professional) component from the technical component of a service.
`52`	Reduced services	Use when the service was partially reduced or not completed as described by the full CPT code.
`53`	Discontinued procedure	Use when the procedure was started but terminated for clinical reasons prior to completion.
`62`	Two surgeons	Use when two surgeons from different specialties work together as primary surgeons.
`80`	Assistant surgeon	Use when an assistant surgeon is involved and paid separately.
`51`	Multiple procedures	Use when multiple additional procedures are billed during the same operative session.
`QY`	Service furnished in part by a PA	Use when a physician assistant performs portions of the service under physician direction and billing requires this identification.
`QX`	Service performed by assistant qualified under NPP rules	Use when an assistant at surgery meets state/supervision requirements and is billed accordingly.
`QK`	Anesthesia-directed CRNA	Use when a CRNA provides anesthesia under an anesthesiologist-directed model (as applicable to facility billing alignment).
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist in postoperative critical care	Use when advanced practice clinicians provide critical care services related to the operative admission (if applicable).

Taxonomy Code	Specialty	Notes
`208600000X`	Surgery Physician	General surgeons performing breast-conserving resections and axillary node procedures.
`207RH0003X`	Surgical Oncology Physician	Surgeons specializing in oncologic breast surgery and complex axillary management.
`207N00000X`	Dermatology Physician	Occasionally involved for skin-sparing approaches or local lesion management when skin excision is required.
`207RG0100X`	Gastroenterology Physician	Data provided; not commonly performing this procedure but listed in associated taxonomies.
`207RI0200X`	Vascular Surgery Physician	Data provided; not typically performing breast resections but listed in associated taxonomies.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C50.911`	Malignant neoplasm of unspecified site of right female breast	Primary malignant diagnosis prompting partial mastectomy with axillary staging on the right side.
`C50.912`	Malignant neoplasm of unspecified site of left female breast	Primary malignant diagnosis prompting partial mastectomy with axillary staging on the left side.
`D05.11`	Lobular carcinoma in situ of right breast	In situ lesion that may prompt excisional management or influence surgical planning on the right.
`D05.12`	Lobular carcinoma in situ of left breast	In situ lesion that may prompt excisional management or influence surgical planning on the left.
`Z85.3`	Personal history of malignant neoplasm of breast	Relevant for surveillance, reconstruction planning, or contralateral procedures in patients with prior breast cancer.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`19301`	Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy)	Alternative CPT for breast-conserving surgery; `19302` differs by explicit inclusion of axillary lymph node removal.
`19307`	Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding pectoralis major muscle	More extensive procedure when full mastectomy with axillary dissection is required instead of a segmental resection.
`38500`	Biopsy or excision of lymph node(s); open, superficial	May be used for isolated superficial nodal biopsies separate from the primary breast resection.
`38525`	Biopsy or excision of lymph node(s); open, deep axillary node(s)	Used when a discrete deep axillary node excision is performed in addition to or instead of sentinel node techniques.
`38745`	Axillary lymphadenectomy; complete	Used for a full axillary dissection when multiple level node removal is required beyond sentinel or targeted node biopsy.
`38900`	Intraoperative identification (eg, mapping) of sentinel lymph node(s) includes injection of non-radioactive dye, when performed (List separately in addition to code for primary procedure)	Billed in addition to `19302` when sentinel node mapping/identification is performed during the same operative session.

CPT 19300: Excision of Male Breast for Gynecomastia

CPT-19301-PARTIAL-MASTECTOMY-BREAST-LESION-EXCISION

CPT 19301: Partial Mastectomy / Excision of Breast Lesion

CPT-19303-SIMPLE-MASTECTOMY-BREAST-REMOVAL

CPT 19303: Simple Mastectomy, Removal of Breast and Nipple–Areolar Complex

CPT-19305-RADICAL-MASTECTOMY-CHEST-WALL-AND-AXILLARY-LYMPH-NODES

CPT 19305: Radical Mastectomy with Chest Wall and Axillary Lymph Node Removal

CPT-19306-RADICAL-MASTECTOMY-TOTAL-CHEST-WALL-AND-LYMPHADENECTOMY

CPT 19306: Radical Mastectomy with Chest Wall and Lymphadenectomy

CPT-19307-MASTECTOMY-REMOVAL-ENTIRE-BREAST

CPT 19307: Mastectomy, Removal of Entire Breast

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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CPT 19302: Breast-Conserving Surgery with Axillary Lymph Node Removal

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Billing Code Overview

National Reimbursement Benchmarks

OpenPayer

CPT 19302: Breast-Conserving Surgery with Axillary Lymph Node Removal

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Billing Code Overview

National Reimbursement Benchmarks

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References