Breast Surgeon Salary Guide 2026: Mastectomy, Lumpectomy, Oncoplastic, and SLNB Income

Breast surgeon salary overview 2026

Breast surgery is a surgical oncology subspecialty focused exclusively on surgical management of breast disease — benign and malignant — including lumpectomy, mastectomy, oncoplastic breast surgery, and breast reconstruction coordination. Breast surgeons typically complete a general surgery residency followed by a 1-year breast surgery fellowship (Society of Surgical Oncology or American Society of Breast Surgeons accredited). The specialty is almost exclusively employed at cancer centers, academic medical centers, or large multispecialty oncology groups — unlike general surgeons who perform breast procedures as part of a broader scope, dedicated breast surgeons build their entire practice around breast disease. Mean total compensation in 2026 ranges from $340,000–$530,000 in academic settings and $380,000–$600,000 in employed comprehensive breast center and cancer center positions.

Income by practice setting

• Academic breast surgical oncology (NCI cancer center): $340,000–$530,000; highest-volume surgical breast cancer program; complex bilateral risk-reducing mastectomy, nipple-sparing mastectomy, oncoplastic reconstruction coordination, inflammatory and locally advanced breast cancer surgery; clinical trial participation (NSABP, ACOSOG Z0011 follow-on trials, SOUND trial); NCI R01 and K award for breast cancer outcomes; fellowship training; PSLF-eligible at all academic employers
• Employed comprehensive breast center (large health system): $380,000–$560,000; single-specialty breast surgery program embedded in breast center with radiology, medical oncology, radiation oncology, plastic surgery, and genetic counseling; multidisciplinary tumor board leadership; high lumpectomy and mastectomy volume; wRVU production bonus; call coverage for emergent breast drainage/hematoma management
• Employed community cancer center or multispecialty oncology group: $380,000–$590,000; breast cancer surgical management in community cancer setting; all-breast scope; collaboration with medical oncology (neoadjuvant chemotherapy decisions, CDK4/6 inhibitor and endocrine therapy management), radiation oncology (partial breast irradiation, APBI, whole breast irradiation), and plastic surgery (immediate reconstruction); wRVU production with production bonus above threshold
• Private breast surgery / surgical oncology practice (rare): $450,000–$700,000; independent breast surgery practice with hospital privileges; uncommon model outside of Texas and Florida; typically involves ASC-based image-guided biopsy income and close integration with a radiology imaging center for workflow efficiency; high cash-pay genetic testing (BRCA, Multigene panel) counseling coordination

Procedure-level billing

• Lumpectomy / partial mastectomy: CPT 19301 (excision, with or without partial mastectomy); professional fee $1,500–$3,000; the most commonly performed breast cancer surgery nationally (BCS conservation surgery); image-guided localization required for non-palpable tumors; positive margin re-excision (CPT 19301 repeat) generates additional billing episode in 15–25% of cases
• Wire localization (preoperative): CPT 19285 (stereotactic guidance) / 19287 (US-guided) / 19283 (with radiologic supervision); professional fee $400–$800; preoperative needle-wire placement for nonpalpable tumor targeting; performed by radiologist or breast surgeon with imaging capability; add-on billing to the lumpectomy procedure
• Radar / magnetic seed localization (SAVI SCOUT, Magseed): CPT 19285 with modifier (or 19499 unlisted in some systems); professional fee $400–$800 for placement; reflector placed days before surgery; eliminates wire scheduling constraint; SAVI SCOUT uses wireless radar; Magseed uses magnetic seed; growing adoption replacing wire localization at breast centers with availability
• Simple mastectomy (total mastectomy): CPT 19303; professional fee $2,500–$4,500; removal of entire breast without skin preservation; older technique; risk-reducing mastectomy for BRCA1/2 carriers; modified radical mastectomy (CPT 19307) for axillary dissection inclusion
• Skin-sparing mastectomy (SSM): CPT 19303 with skin-sparing documentation; professional fee $2,500–$4,500; skin envelope preservation to facilitate immediate reconstruction; standard of care at comprehensive breast centers for patients undergoing mastectomy who are reconstruction candidates; requires plastic surgery collaboration for same-day reconstruction (tissue expander, implant, or flap)
• Nipple-sparing mastectomy (NSM): CPT 19303 with NSM documentation; professional fee $2,800–$5,000; preservation of the nipple-areola complex; requires oncologic clearance (frozen section or permanent section of subareolar tissue); highest patient satisfaction of all mastectomy techniques; growing adoption as NSM evidence base strengthens; robotic-assisted NSM (same codes with robotic modifier) emerging at high-volume programs
• Bilateral prophylactic mastectomy: CPT 19303 × 2 (bilateral modifier); professional fee $4,000–$8,000 for bilateral; BRCA1/2, PALB2, ATM, CHEK2 high-risk patients; contralateral prophylactic mastectomy (CPM) at time of cancer surgery; growing demand driven by genetic testing expansion (multi-gene panels) and patient preference
• Sentinel lymph node biopsy (SLNB): CPT 38900 (intraoperative mapping and sentinel lymph node identification); professional fee $1,200–$2,500; lymphatic mapping with radiotracer (Tc-99m sulfur colloid) and/or isosulfan blue dye; intraoperative gamma probe localization; replacement of routine axillary dissection for clinically node-negative breast cancer (ACOSOG Z0011 and SENTINA trial evidence); performed at same setting as lumpectomy or mastectomy
• Axillary lymph node dissection (ALND): CPT 38745; professional fee $1,800–$3,200; complete level I–III axillary lymph node removal; declining frequency with SLNB adoption and ACOSOG Z0011 criteria; reserved for clinically node-positive disease, positive sentinel nodes not meeting Z0011 criteria, or inflammatory breast cancer
• Oncoplastic breast surgery: Level 1 (CPT 19301 + volume displacement code, e.g., 19350 mastopexy) / Level 2 (CPT 19301 + reduction mammaplasty CPT 19318); professional fee $3,000–$6,000 for combined oncoplastic; combines oncologic lumpectomy with simultaneous reshaping to improve cosmetic outcome; growing subspecialty; ASBS oncoplastic certification pathway; reduces re-excision rates by broader initial excision with reshaping
• Image-guided core needle biopsy (ultrasound): CPT 19083 (US-guided breast biopsy); professional fee $500–$900; some breast surgeons perform image-guided biopsy in addition to surgical procedures; ultrasound-guided core biopsy of breast masses, axillary lymph nodes, and suspicious areas; requires ultrasound equipment and MQSA oversight if using mammography

Genetic testing and high-risk surveillance coordination

Breast surgeons at comprehensive cancer centers increasingly coordinate hereditary breast cancer risk management — ordering multi-gene panel testing (Invitae, Myriad myRisk, Color Genomics), interpreting results (BRCA1/2, PALB2, ATM, CHEK2, CDH1, PTEN), counseling patients about risk-reducing options, and performing risk-reducing mastectomy. This practice generates E&M billing for genetic counseling visits (CPT 99213–99215 or dedicated genetic counseling codes CPT 96040) and drives surgical volume as more high-risk patients are identified. High-risk surveillance programs (MRI + mammogram alternating for BRCA carriers) generate referral volume for breast center radiology and cement the breast surgeon's role as the central coordinator of the patient's breast health journey.

Geographic variation in breast surgeon compensation

• NCI-designated cancer centers and major academic programs (MD Anderson, Memorial Sloan Kettering, Mayo, Northwestern, Vanderbilt): $360,000–$570,000; highest-volume and most complex breast cancer surgery; clinical trial leadership; SSO fellowship training program; NCI R01 for breast cancer outcomes; PSLF-eligible employment
• Major regional comprehensive breast centers (Moffitt, Cleveland Clinic, Penn Medicine, Huntsman): $400,000–$590,000; high-volume employed model; multidisciplinary tumor board leadership; immediate reconstruction coordination with plastic surgery; strongest wRVU production range
• Sun Belt community cancer markets (FL, TX, AZ, GA): $400,000–$600,000; high breast cancer incidence in aging populations; growing comprehensive breast center investment by community health systems; screening mammography → biopsy → surgery pathway well-established; strong demand for dedicated breast surgeons outside of academic centers
• Rural and community hospital markets: $380,000–$540,000; general surgeons perform most breast surgery in rural markets; dedicated breast surgeons in rural areas are rare; significant access gap; locum breast surgery coverage at community programs growing

What we see at Ava Health

Breast surgery is the physician subspecialty where multidisciplinary coordination is most explicitly built into the job description — breast surgeons who thrive in their practice are those who genuinely enjoy the tumor board-based decision making, the genetic counseling interface, the plastic surgery reconstruction partnership, and the longitudinal relationship with patients through neoadjuvant chemotherapy, surgery, adjuvant radiation, and endocrine therapy. What we hear consistently from breast surgeons in our network is that the program's structural investment in the comprehensive breast center model (dedicated space, co-located imaging, on-site genetic counseling, same-day multidisciplinary tumor board) is the most important practice environment variable. Programs that expect breast surgeons to coordinate complex cases without co-located multidisciplinary infrastructure are at a significant disadvantage in both quality outcomes and physician satisfaction.

Related: General Surgeon Salary Guide, Plastic Surgeon Salary Guide, Hematologist-Oncologist Salary Guide, Gynecologic Oncologist Salary Guide.