CPT 19300
Global 090 ActiveMastectomy for gynecomastia
CPT 19300 Billing & Documentation Guide
CPT code 19300 (Mastectomy for gynecomastia) is classified under Anesthesia with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 5.18, a non-facility practice expense RVU of 12.69, and a malpractice RVU of 1.21, a total non-facility RVU of 19.08 and facility RVU of 12.75. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $653.5, though rates vary from $557.92 to $824.91 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 19300, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 19300 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 19300 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 19300
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 5.18 | 5.18 |
| Practice Expense RVU | 12.69 | 6.36 |
| Malpractice RVU | 1.21 | 1.21 |
| Total RVU | 19.08 | 12.75 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 19300
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $702.67 | $452.5 | $662.17 - $824.91 | 29 |
| Florida | $676.96 | $464.83 | $638.97 - $716.46 | 3 |
| Georgia | $625.99 | $424.29 | $599.27 - $652.71 | 2 |
| Illinois | $660.41 | $456.12 | $623.17 - $692.96 | 4 |
| Michigan | $627.91 | $429.37 | $605.63 - $650.18 | 2 |
| North Carolina | $594.3 | $397.04 | $594.3 - $594.3 | 1 |
| New York | $709.02 | $473.15 | $604.09 - $763.11 | 5 |
| Ohio | $600.74 | $407.7 | $600.74 - $600.74 | 1 |
| Pennsylvania | $632.94 | $425.86 | $600.31 - $665.58 | 2 |
| Texas | $628.8 | $420.65 | $596.27 - $657.61 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 19300
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 19300 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 00400 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0061T | Column 1 (primary), can be billed with modifier | Yes | More extensive procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 19300
What does CPT code 19300 mean? +
CPT code 19300 represents: Mastectomy for gynecomastia. It's in the Anesthesia category with a global period of 090.
What is the Medicare reimbursement for CPT 19300? +
The 2026 Medicare national average non-facility payment for CPT 19300 is $653.5. Rates range from $557.92 to $824.91 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 19300? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 19300? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team