Place breast rad tube/caths

CPT code 19298 covers the placement of radiation tubes or catheters directly into breast tissue, typically used for targeted radiation therapy after breast cancer surgery. This procedure allows oncologists to deliver concentrated radiation doses precisely where cancer cells were removed.

Showing rates for

National Average

Base Medicare rate

$831.31

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

5.75

PE RVU (NF)

19.47

MP RVU

0.48

Total RVU

25.7

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Verify site of service before billing: The $519.17 difference between non-facility ($831.31) and facility ($312.14) rates makes place-of-service code accuracy critical
Impact: Incorrect POS coding can result in $519.17 underpayment or trigger recoupment demands from Medicare
Bill imaging guidance separately with modifier 59 when performed: Ultrasound (76942) or CT (77012) guidance is not bundled into 19298 but requires distinct documentation
Impact: Additional $100-$300 in reimbursement when imaging guidance is properly documented and billed separately
Document the number of catheters placed in operative notes: Multiple catheter placement using the same code may require modifier 59 or documentation explaining medical necessity for single-code billing
Impact: Prevents downcoding or bundling; ensures appropriate payment for complex multi-catheter placements
Coordinate with radiation oncology for subsequent treatment codes: 19298 is placement only; the actual radiation delivery (77770-77772 series) is billed separately by radiation oncology
Impact: Avoids duplicate billing disputes and ensures complete revenue capture across the treatment continuum
Appeal facility rate payments when performed in non-facility settings: Some payers incorrectly apply the $312.14 facility rate even when performed in office-based or ASC settings
Impact: Successful appeals recover the $519.17 difference per procedure, significantly impacting practice revenue
Bundle appropriately with same-day lumpectomy when applicable: If performed at the time of initial lumpectomy, verify payer policies on bundling vs. separate billing with modifier 51 or 59

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 19298 in 2025?

Medicare pays $831.31 for CPT 19298 in non-facility settings and $312.14 in facility settings under the 2025 Physician Fee Schedule. The rate difference reflects practice expense variations between settings.

How many RVUs is CPT code 19298 worth?

CPT 19298 has a total of 25.7 RVUs, consisting of 5.75 work RVUs, 19.47 non-facility practice expense RVUs (3.42 facility PE RVUs), and 0.48 malpractice RVUs.

Can CPT 19298 be billed with a lumpectomy on the same day?

Yes, CPT 19298 can typically be billed with lumpectomy codes (19301, 19302) when performed during the same session, but proper documentation of distinct procedures and appropriate modifier use (such as modifier 59) may be required depending on payer policies.

What modifiers are commonly used with CPT code 19298?

Common modifiers for 19298 include RT/LT for laterality specification, modifier 50 for bilateral procedures, modifier 59 for distinct procedural services (especially with imaging guidance), and modifier 78 for catheter repositioning during the global period.

Is imaging guidance included in CPT 19298 or billed separately?

Imaging guidance is not bundled into CPT 19298 and can be billed separately using codes such as 76942 (ultrasound) or 77012 (CT guidance), provided the imaging is separately documented and modifier 59 is appended when appropriate.

What documentation is required for Medicare to pay CPT 19298?

Required documentation includes breast laterality, number of catheters placed, imaging guidance method, approach (percutaneous or intraoperative), medical necessity justification including cancer characteristics, catheter position verification, and the plan for subsequent radiation treatment.

How does CPT 19298 differ from other breast brachytherapy codes?

CPT 19298 specifically covers the placement of radiation tubes or catheters into breast tissue, while subsequent radiation delivery is coded separately using the 77770-77772 series. It differs from 19296-19297 (breast reconstruction codes) and focuses solely on the catheter insertion procedure for therapeutic purposes.