CPT 19302: Partial Mastectomy with Axillary Lymph Node Removal

Medicare pays $877 and commercial payers pay $3407 on average nationally for this procedure.

CPT code 19302 describes a surgical procedure in which the provider removes a breast lesion with surrounding margins or a significant portion of the breast (segment or quadrant) and performs removal of axillary lymph nodes; service type: breast surgery (partial mastectomy with axillary node dissection); typical site of service: hospital operating room or ambulatory surgical center for oncologic breast procedures.

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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: Partial Mastectomy with Axillary Lymph Node Removal

Medicare pays $877 and commercial payers pay $3407 on average nationally for this procedure.

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Sign up for cpt 19302 policy alerts

Get alerted when payer policies referencing 19302 are released or updated.

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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.

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.

Related Modifiers

8 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
80	CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…	- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
51	Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…	- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
208600000X	Surgery Physician	A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of s…
207RH0003X	Hematology & Oncology Physician	An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy t…
207N00000X	Dermatology Physician	A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genital…
207RG0100X	Gastroenterology Physician	An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This…
207RI0200X	Infectious Disease Physician	An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this…
211D00000X	Podiatric Assistant	An individual who assists a podiatrist in tasks, such as exposing and developing x-rays; taking and recording patient histories; assisting in biomecha…
343900000X	Non-emergency Medical Transport (VAN)	A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The …
2355S0801X	Speech-Language Assistant	Speech, Language and Hearing Service Providers · Specialist/Technologist

Related Payer Policy Updates

Specialty: General Surgery1 / 3

10 rows

Policy	Payer	Effective Date
Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in Adults	Premera Bluecross	2026-09-01
Site of Service Ambulatory Surgical Center (ASC) Select — Surgical or Diagnostic Procedures in Adults	Premera Bluecross	2026-09-01
Site of Service Ambulatory Service Center (ASC) Select	Premera Bluecross	2026-09-01
Site of Service Ambulatory Surgical Center (ASC) Select — Site of Service for Ambulatory Surgical Procedures (ASC Select)	Premera Bluecross	2026-09-01
Site of Service Ambulatory Service Center (ASC) Select	Premera Bluecross	2026-09-01
Outpatient Surgical Procedures - Site of Service	sierra health and life	2026-08-01
Medical Necessity Guidelines — Inpatient Surgical Care	Mass General Brigham Health Plan	2026-08-01
Ambulatory Surgery Center (ASC) - Site of Care Policy	Kaiser Permanente	2026-08-01
Inpatient Surgical Site of Service	Providence Health Plan	2026-07-01
Removal of Implantable Devices	Blue Cross Blue Shield - Rhode Island	2026-07-01

CPT 19300: Excision of Male Gynecomastia

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

CPT 19301: Partial Mastectomy / Lumpectomy (Breast-Conserving Surgery)

CPT-19303-SIMPLE-MASTECTOMY-BREAST-REMOVAL

CPT 19303: Simple (Total) Mastectomy

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

CPT 19305: Radical Mastectomy with Axillary Lymph Node Removal

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

CPT 19306: Radical Mastectomy with Chest Muscle and Lymph Node Removal

CPT-19307-MASTECTOMY-REMOVAL-ENTIRE-BREAST

CPT 19307: Mastectomy, Complete Removal of Breast

Frequently Asked Questions

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

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.

Related Modifiers

8 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
80	CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…	- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
51	Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…	- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
208600000X	Surgery Physician	A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of s…
207RH0003X	Hematology & Oncology Physician	An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy t…
207N00000X	Dermatology Physician	A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genital…
207RG0100X	Gastroenterology Physician	An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This…
207RI0200X	Infectious Disease Physician	An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this…
211D00000X	Podiatric Assistant	An individual who assists a podiatrist in tasks, such as exposing and developing x-rays; taking and recording patient histories; assisting in biomecha…
343900000X	Non-emergency Medical Transport (VAN)	A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The …
2355S0801X	Speech-Language Assistant	Speech, Language and Hearing Service Providers · Specialist/Technologist

Related Payer Policy Updates

Specialty: General Surgery1 / 3

10 rows

Policy	Payer	Effective Date
Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in Adults	Premera Bluecross	2026-09-01
Site of Service Ambulatory Surgical Center (ASC) Select — Surgical or Diagnostic Procedures in Adults	Premera Bluecross	2026-09-01
Site of Service Ambulatory Service Center (ASC) Select	Premera Bluecross	2026-09-01
Site of Service Ambulatory Surgical Center (ASC) Select — Site of Service for Ambulatory Surgical Procedures (ASC Select)	Premera Bluecross	2026-09-01
Site of Service Ambulatory Service Center (ASC) Select	Premera Bluecross	2026-09-01
Outpatient Surgical Procedures - Site of Service	sierra health and life	2026-08-01
Medical Necessity Guidelines — Inpatient Surgical Care	Mass General Brigham Health Plan	2026-08-01
Ambulatory Surgery Center (ASC) - Site of Care Policy	Kaiser Permanente	2026-08-01
Inpatient Surgical Site of Service	Providence Health Plan	2026-07-01
Removal of Implantable Devices	Blue Cross Blue Shield - Rhode Island	2026-07-01

CPT 19300: Excision of Male Gynecomastia

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

CPT 19301: Partial Mastectomy / Lumpectomy (Breast-Conserving Surgery)

CPT-19303-SIMPLE-MASTECTOMY-BREAST-REMOVAL

CPT 19303: Simple (Total) Mastectomy

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

CPT 19305: Radical Mastectomy with Axillary Lymph Node Removal

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

CPT 19306: Radical Mastectomy with Chest Muscle and Lymph Node Removal

CPT-19307-MASTECTOMY-REMOVAL-ENTIRE-BREAST

CPT 19307: Mastectomy, Complete Removal of Breast

Frequently Asked Questions

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: Partial Mastectomy with Axillary Lymph Node Removal

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National Reimbursement Benchmarks

OpenPayer

CPT 19302: Partial Mastectomy with Axillary Lymph Node Removal

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National Reimbursement Benchmarks

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

References

CPT 19302: Partial Mastectomy with Axillary Lymph Node Removal

Sign up for cpt 19302 policy alerts

National Reimbursement Benchmarks

CPT 19302: Partial Mastectomy with Axillary Lymph Node Removal

Sign up for cpt 19302 policy alerts

National Reimbursement Benchmarks

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What does CPT 19302 specifically describe and how does it differ from CPT 19301?

Where is CPT 19302 typically performed?

Which other CPT codes are commonly billed with or instead of 19302 for axillary staging?

What diagnosis codes are associated with CPT 19302 in this content?

What preoperative and postoperative workflows and documentation elements are highlighted for procedures billed with 19302?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What does CPT 19302 specifically describe and how does it differ from CPT 19301?

Where is CPT 19302 typically performed?

Which other CPT codes are commonly billed with or instead of 19302 for axillary staging?

What diagnosis codes are associated with CPT 19302 in this content?

What preoperative and postoperative workflows and documentation elements are highlighted for procedures billed with 19302?

References