Partial mastectomy

What is CPT Code 19301?

Partial mastectomy (lumpectomy) — surgical removal of a breast tumor and a margin of surrounding normal tissue while preserving most of the breast. Standard surgical treatment for early-stage breast cancer when appropriate.

The Medicare reimbursement rate shown above is the amount the federal government has determined is a reasonable payment for this service. Hospitals and providers that participate in Medicare have agreed to accept these rates from Medicare patients.

Who typically bills this:Breast surgeon + hospital or ASC facility + anesthesiologist

Common Billing Errors for CPT 19301

• !Re-excision (19301 billed a second time) for margin clearance without documentation of the separate procedure
• !Sentinel lymph node mapping and biopsy billed separately when performed in the same surgical session
• !Post-operative visits within 90 days billed separately by the operating surgeon

Red Flags on Your Bill

Negotiation Tips for CPT 19301

1. 1Lumpectomy is often performed as same-day surgery — verify whether an overnight stay is included in the facility charge
2. 290-day global surgical period means post-op office visits are bundled in the surgeon's fee
3. 3Sentinel lymph node biopsy may be a legitimate separate code — verify the operative report

Codes That Often Appear With This One

These CPT codes commonly appear on the same bill. Review each one to spot potential bundling errors or duplicate charges.

Found CPT 19301 on Your Bill?

If you see CPT code 19301 on a hospital or medical bill, compare the charged amount to the Medicare rate above. If your bill shows a significantly higher charge, you may have grounds to negotiate.

1. Note the amount charged for CPT 19301 on your itemized bill
2. Compare it to the Medicare rate above — calculate the markup
3. Call the billing department and use the Medicare rate as your anchor:“I see CPT code 19301 billed at [amount]. The Medicare rate for this procedure is $660.79. I'd like to discuss a fair adjustment.”