2025 CPT code 19305
(Active) Effective Date: N/A Revision Date: N/A Surgery - Mastectomy Surgery Feed
Radical mastectomy, including pectoral muscles and axillary lymph nodes.
Modifiers 50 (bilateral procedure), 59 (distinct procedural service) and others may apply depending on the specific circumstances of the procedure.
Medical necessity for a radical mastectomy is established when there is a diagnosis of breast cancer, and the extent of the disease requires the removal of the breast, pectoral muscles, and axillary lymph nodes for complete tumor resection and optimal cancer control.This often occurs in cases with locally advanced disease, positive lymph nodes, or specific tumor characteristics.
The surgical oncologist or general surgeon is primarily responsible for performing the radical mastectomy.This may involve pre-operative assessment, surgical technique, post-operative care, and follow-up.Other specialists such as plastic surgeons might be involved in the reconstruction portion of the process if that is part of the overall plan.
In simple words: The surgeon removes the entire breast, nipple, and surrounding skin, along with the chest muscles and lymph nodes under the arm. This is typically done to treat or prevent breast cancer.Additional procedures, like reconstruction, may be needed later.
This procedure involves the complete removal of the ipsilateral breast tissue, including the nipple and areola, the pectoral muscles (major and/or minor), and the axillary lymph nodes.It is performed for the treatment or prevention of breast cancer. The procedure may include additional steps such as the placement of a drainage device and may necessitate subsequent reconstructive surgery.
Example 1: A 45-year-old female patient presents with a large, invasive ductal carcinoma in the right breast.A radical mastectomy (19305) is performed to remove the entire breast, pectoral muscles, and axillary lymph nodes to ensure complete tumor removal and prevent recurrence., A 60-year-old female patient with a strong family history of breast cancer undergoes a prophylactic bilateral radical mastectomy (19305-50).This preventative procedure removes both breasts to reduce the risk of developing breast cancer., A 52-year-old female patient undergoes a radical mastectomy (19305) of the left breast for invasive lobular carcinoma.During surgery, the surgeon determines that additional lymph node dissection is needed. This is considered inclusive within the 19305 code. Post-operative care involves managing pain, wound care, and monitoring for complications.
Detailed operative report describing the extent of resection (including the removal of pectoral muscles and axillary lymph nodes), pathology report confirming the diagnosis and the margins of the resection, imaging studies (mammogram, ultrasound, MRI) demonstrating the tumor location and size, and any other relevant clinical information.
** Intraoperative placement of clips is not separately reported. For immediate or delayed insertion of an implant, see codes 19340 and 19342.
- Revenue Code: P1A (Major Procedure - Breast)
- RVU: This information is not available in the provided text.Consult the current CPT codebook or a relevant fee schedule for RVU values and reimbursement information.
- Global Days: This information is not available in the provided text. The global surgical package may vary depending on payer and other factors.
- Payment Status: Active
- Modifier TC rule: This information is not applicable to this code.
- Fee Schedule: This information is not available in the provided text. Consult a reliable fee schedule database for historical fee data.
- Specialties:Surgical Oncology, General Surgery, Breast Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center