CPT® Code 19305

Radical mastectomy, as defined by CPT® Code 19305, is a surgical procedure that involves the comprehensive removal of the entire breast, including the nipple and areola, along with the excision of the pectoralis major and minor muscles and the axillary lymph nodes. This procedure is typically indicated for patients diagnosed with breast cancer, where extensive tissue removal is necessary to ensure complete excision of malignant cells. The surgical approach often involves making an elliptical incision that encompasses the breast and extends into the axilla, an area known as the tail of Spence. During the operation, the surgeon removes the breast tissue, skin, areola, and nipple in a single unit, referred to as en bloc, along with the underlying pectoral muscles. Additionally, the axillary lymph nodes are meticulously dissected from the underlying axillary vein, as well as the adjacent nerves and muscles, to facilitate their removal. In certain cases, a more extensive procedure known as an Urban-type radical mastectomy may be performed, which includes the excision of internal mammary lymph nodes along with the previously mentioned structures. This procedure is critical in managing advanced breast cancer and may involve further dissection of surrounding tissues, including portions of the rectus fascia, latissimus dorsi muscle, and clavicle. The surgical site is then closed, and if there is insufficient skin for closure, a myocutaneous graft may be utilized, or a breast reconstruction procedure may be performed prior to closure. This comprehensive approach aims to achieve optimal oncological outcomes while addressing the physical changes resulting from the surgery.