CPT 19305: Radical Mastectomy with Chest Wall and Axillary Lymph Node Removal
CPT code 19305 denotes a radical mastectomy involving removal of the entire breast, nipple–areolar complex, chest (pectoral) muscles, and axillary lymph nodes. It is a high-acuity surgical oncology procedure used for extensive or locally advanced breast cancer and remains clinically significant for definitive cancer control in selected patients. Nationally, accurate coding of this procedure affects clinical documentation, surgical quality measurement, and payment pathways for complex oncologic care.
This analysis covers major national payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, coding scope, common associated diagnoses, and related CPT references. The publication provides benchmarks and policy-relevant observations on coding alignment and procedural classification for radical mastectomy, plus guidance on where to locate supporting diagnosis codes in medical records.
Readers will learn what CPT code 19305 represents, why it matters for surgical oncology services, and how it connects to adjacent CPT codes for mastectomy. The report highlights clinical scenarios that commonly map to this code and summarizes the typical site of service and service type to support billing, coding review, and administrative oversight.
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Billing Code Overview
CPT code 19305 describes a radical mastectomy in which the provider removes the entire breast, nipples, the skin surrounding the nipple–areolar complex, the pectoral (chest) muscles, and axillary lymph nodes. This procedure is an extensive oncologic surgery performed for invasive or locally advanced breast malignancies when removal of the chest wall musculature and regional lymph nodes is indicated.
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Service type: Surgical oncology procedure (radical mastectomy)
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Typical site of service: Hospital operating room or inpatient surgical unit
National Reimbursement Benchmarks
Commercial averages generally sit above Medicare for CPT 19305: Blue Cross Blue Shield, Cigna, UnitedHealth Group, Aetna, and BUCA all show higher mean rates than Medicare’s mean of $1,109.20, with BUCA’s mean at $1,430.20 representing a roughly $321.00 premium over Medicare. UnitedHealth Group and Cigna lead commercial means at $1,908.00 and $1,832.50 respectively, creating a commercial band that is materially above Medicare’s central tendency.
Dispersion measured as the interquartile spread (P75 minus P25) varies notably by payer. Blue Cross Blue Shield’s IQR is $793.30 and Cigna’s is $1,301.10, indicating wider variation, while Aetna’s IQR is $329.00 and Medicare’s IQR is $88.00, indicating much tighter clustering around the median. UnitedHealth Group’s IQR is $1,252.20 and BUCA’s IQR is $900.10, placing them in the mid-to-high variability range compared with other payers.