| CHARGE CODE | CODE DESCRIPTION | CPT CODE | REV CODE | REVENUE AREA | CHARGE | MEDICARE VOL | TPP VOL | MCR Reimb | TPP Reimb*.62 | MCR Cost | TPP Cost | MCR Profit | TPP Profit | Overall MCR Profit | Overall TPP Profit |
| 49210 | BIOPSY BREAST 1ST LESION STRTCTC | 19081 | 320 | 1137 | 2980.8 | 56 | 150 | $1,052.63 | 1848.096 | 1569.98736 | 1569.98736 | -1557.98736 | 278.10864 | -87247.29216 | 41716.296 |
| 49211 | BIOPSY BREAST ADD LESION STRTCTC | 19083 | 320 | 1137 | 2980.8 | 56 | 160 | $1,052.63 | 1848.096 | 1569.98736 | 1569.98736 | -1557.98736 | 278.10864 | -87247.29216 | 44497.3824 |
| 49212 | BIOPSY BREAST 1ST LESION STRTCTC | 19085 | 320 | 1137 | 2980.8 | 23 | 101 | $1,052.63 | 1848.096 | 1569.98736 | 1569.98736 | -1557.98736 | 278.10864 | -35833.70928 | 28088.97264 |
| 49213 | BIOPSY BREAST PERCUT W/O IMAGING GUIDANCE | 19100 | 360 | 1137 | 826.8 | 58 | 115 | $487.34 | 512.616 | 334.27524 | 334.27524 | -322.27524 | 178.34076 | -18691.96392 | 20509.1874 |
| 49214 | BIOPSY OF BREAST, OPEN | 19101 | 360 | 1137 | 3944.25 | 37 | 76 | $2,167.64 | 2445.435 | 1594.660275 | 1594.660275 | -1582.660275 | 850.774725 | -58558.430175 | 64658.8791 |
| 49217 | CRYOSURG ABLATE FIBROADENOMA, EACH | 19105 | 360 | 1137 | 6059.85 | 21 | 32 | $3,012.77 | 3757.107 | 2449.997355 | 2449.997355 | -2437.997355 | 1307.109645 | -51197.944455 | 41827.50864 |
| 49218 | NIPPLE EXPLORATION | 19110 | 360 | 1137 | 3944.25 | 12 | 14 | $2,167.64 | 2445.435 | 1594.660275 | 1594.660275 | -1582.660275 | 850.774725 | -18991.9233 | 11910.84615 |
| 49219 | EXCISE BREAST DUCT FISTULA | 19112 | 360 | 1137 | 3944.25 | 14 | 17 | $2,167.64 | 2445.435 | 1594.660275 | 1594.660275 | -1582.660275 | 850.774725 | -22157.24385 | 14463.170325 |
| 49220 | REMOVAL OF BREAST LESION | 19120 | 360 | 1137 | 3944.25 | 76 | 87 | $2,167.64 | 2445.435 | 1594.660275 | 1594.660275 | -1582.660275 | 850.774725 | -120282.1809 | 74017.401075 |
| 49221 | EXCISION, BREAST LESION | 19125 | 360 | 1137 | 3944.25 | 45 | 90 | $2,167.64 | 2445.435 | 1594.660275 | 1594.660275 | -1582.660275 | 850.774725 | -71219.712375 | 76569.72525 |
| 49223 | REMOVAL OF CHEST WALL LESION | 19260 | 360 | 1137 | 3076.44 | 22 | 43 | $1,341.41 | 1907.3928 | 1243.804692 | 1243.804692 | -1231.804692 | 663.588108 | -27099.703224 | 28534.288644 |
| 49227 | PLACE BALLOON CATHETER FOR RADIOELEMENT APP | 19296 | 360 | 1137 | 10810.92 | 5 | 24 | $7,464.32 | 6702.7704 | 4370.854956 | 4370.854956 | -4358.854956 | 2331.915444 | -21794.27478 | 55965.970656 |
| 49229 | PLACE BRACHYTHERAPY CATHETER | 19298 | 360 | 1137 | 10810.92 | 10 | 32 | $7,464.32 | 6702.7704 | 4370.854956 | 4370.854956 | -4358.854956 | 2331.915444 | -43588.54956 | 74621.294208 |
| 49230 | REMOVAL OF BREAST TISSUE | 19300 | 360 | 1137 | 3944.25 | 21 | 68 | $2,167.64 | 2445.435 | 1594.660275 | 1594.660275 | -1582.660275 | 850.774725 | -33235.865775 | 57852.6813 |
| 49231 | PARTIAL MASTECTOMY | 19301 | 360 | 1137 | 3944.25 | 24 | 45 | $2,167.64 | 2445.435 | 1594.660275 | 1594.660275 | -1582.660275 | 850.774725 | -37983.8466 | 38284.862625 |
| 49232 | P-MASTECTOMY W LYMPHADENECTOMY | 19302 | 360 | 1137 | 7608.72 | 21 | 65 | $4,150.45 | 4717.4064 | 3076.205496 | 3076.205496 | -3064.205496 | 1641.200904 | -64348.315416 | 106678.05876 |
| 49233 | MASTECTOMY, SIMPLE, COMPLETE | 19303 | 360 | 1137 | 6059.85 | 18 | 47 | $3,012.77 | 3757.107 | 2449.997355 | 2449.997355 | -2437.997355 | 1307.109645 | -43883.95239 | 61434.153315 |
| 49234 | MASTECTOMY, SUBCUTANEOUS | 19304 | 360 | 1137 | 6059.85 | 17 | 56 | $3,012.77 | 3757.107 | 2449.997355 | 2449.997355 | -2437.997355 | 1307.109645 | -41445.955035 | 73198.14012 |
| 49235 | MASTECTOMY, MODIFIED RADICAL | 19307 | 360 | 1137 | 7608.72 | 15 | 63 | $4,150.45 | 4717.4064 | 3076.205496 | 3076.205496 | -3064.205496 | 1641.200904 | -45963.08244 | 103395.656952 |
| 49236 | SUSPENSION OF BREAST | 19316 | 360 | 1137 | 6059.85 | 11 | 2 | $3,012.77 | 3757.107 | 2449.997355 | 2449.997355 | -2437.997355 | 1307.109645 | -26817.970905 | 2614.21929 |
| 49237 | REDUCTION OF LARGE BREAST | 19318 | 360 | 1137 | 7608.72 | 9 | 12 | $4,150.45 | 4717.4064 | 3076.205496 | 3076.205496 | -3064.205496 | 1641.200904 | -27577.849464 | 19694.410848 |
| 49238 | ENLARGE BREAST | 19324 | 360 | 1137 | 7608.72 | 0 | 23 | $4,150.45 | 4717.4064 | 3076.205496 | 3076.205496 | -3064.205496 | 1641.200904 | 0 | 37747.620792 |
| 49239 | ENLARGE BREASE WITH IMPLANT | 19325 | 360 | 1137 | 10810.92 | 0 | 25 | $7,464.32 | 6702.7704 | 4370.854956 | 4370.854956 | -4358.854956 | 2331.915444 | 0 | 58297.8861 |
| 49240 | REMOVAL OF BREAST IMPLANT | 19328 | 360 | 1137 | 6059.85 | 5 | 13 | $3,012.77 | 3757.107 | 2449.997355 | 2449.997355 | -2437.997355 | 1307.109645 | -12189.986775 | 16992.425385 |
| 49241 | REMOVAL OF BREAST IMPLANT MATERIAL | 19330 | 360 | 1137 | 6059.85 | 0 | 16 | $3,012.77 | 3757.107 | 2449.997355 | 2449.997355 | -2437.997355 | 1307.109645 | 0 | 20913.75432 |
| 49242 | IMMEDIATE BREAST PROSTHESIS | 19340 | 360 | 1137 | 7608.72 | 0 | 34 | $4,150.45 | 4717.4064 | 3076.205496 | 3076.205496 | -3064.205496 | 1641.200904 | 0 | 55800.830736 |
| 49243 | DELAYED BREAST PROSTHESIS | 19342 | 360 | 1137 | 10810.92 | 17 | 27 | $7,464.32 | 6702.7704 | 4370.854956 | 4370.854956 | -4358.854956 | 2331.915444 | -74100.534252 | 62961.716988 |
| 49244 | BREAST RECONSTRUCTION | 19350 | 360 | 1137 | 3944.25 | 4 | 47 | $2,167.64 | 2445.435 | 1594.660275 | 1594.660275 | -1582.660275 | 850.774725 | -6330.6411 | 39986.412075 |
| 49245 | CORRECT INVERTED NIPPLE(S) | 19355 | 360 | 1137 | 6059.85 | 0 | 3 | $3,012.77 | 3757.107 | 2449.997355 | 2449.997355 | -2437.997355 | 1307.109645 | 0 | 3921.328935 |
| 49246 | BREAST RECONSTRUCTION | 19357 | 360 | 1137 | 10810.92 | 6 | 25 | $7,464.32 | 6702.7704 | 4370.854956 | 4370.854956 | -4358.854956 | 2331.915444 | -26153.129736 | 58297.8861 |
| 49247 | BREAST RECONSTRUCTION | 19366 | 360 | 1137 | 6059.85 | 7 | 24 | $3,012.77 | 3757.107 | 2449.997355 | 2449.997355 | -2437.997355 | 1307.109645 | -17065.981485 | 31370.63148 |
| 49248 | SURGERY OF BREAST CAPSULE | 19370 | 360 | 1137 | 6059.85 | 5 | 12 | $3,012.77 | 3757.107 | 2449.997355 | 2449.997355 | -2437.997355 | 1307.109645 | -12189.986775 | 15685.31574 |
| 49249 | REMOVAL OF BREAST CAPSULE | 19371 | 360 | 1137 | 6059.85 | 6 | 9 | $3,012.77 | 3757.107 | 2449.997355 | 2449.997355 | -2437.997355 | 1307.109645 | -14627.98413 | 11763.986805 |
| 49250 | REVISE BREAST RECONSTRUCTION | 19380 | 360 | 1137 | 7608.72 | 4 | 8 | $4,150.45 | 4717.4064 | 3076.205496 | 3076.205496 | -3064.205496 | 1641.200904 | -12256.821984 | 13129.607232 |
| 49251 | DESIGN CUSTOM BREAST IMPLANT | 19396 | 360 | 1137 | 6059.85 | 0 | 23 | $3,012.77 | 3757.107 | 2449.997355 | 2449.997355 | -2437.997355 | 1307.109645 | 0 | 30063.521835 |
| 49252 | BREAST SURGERY PROCEDURE | 19499 | 360 | 1137 | 3944.25 | 2 | 1 | $2,167.64 | 2445.435 | 1594.660275 | 1594.660275 | -1582.660275 | 850.774725 | -3165.32055 | 850.774725 |