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CPT 19316 Fee Schedule

Last Verified: December 2025

Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.

Mastopexy
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Integumentary System

Common Place of Service

22 - On Campus Outpatient Hospital

24 - Ambulatory Surgical Center

Common Modifiers

None

LT - Left side of body

RT - Right side of body

Complexity LevelHigh

National average reimbursement for CPT 19316 by major payers:

bcbs

$1,040.29

uhc

$1,008.18

aetna

$1,067.47

cigna

$1,311.34

Preview provider-level rates for...
For billing codeCPT 19316
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 19316

United
19316$3623.001306421268 - COLORADO UROLOGIC SURGERY CENTER, LLC, COLORADO UROLOGIC SURGERY CENTER851926897 - (CO) COLORADO UROLOGIC SURGERY CENTER LLCCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
19316$6623.001528121316 - SAINT LUKES SOUTH SURGERY CENTER LLC201721929 - (KS) SAINT LUKES SOUTH SURGERY CENTER LLCKSAmbulatory Surgical Clinic/Center (261QA1903X)
United
19316$1094.001720085384 - ELMHURST OUTPATIENT SURGERY CENTER LLC364150045 - (IL) ELMHURST OUTPATIENT SURGERY CENTER, LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
19316$2100.001972508174 - VILLAGE SURGICENTER, LIMITED PARTNERSHIP, VILLAGE SURGICENTER OF ERIE760555703 - (PA) VILLAGE SURGICENTER LIMITED PARTNERSHIPPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
19316$2527.001609537992 - NCH BONITA AMBULATORY SURGERY CENTER, LLC873854125 - (FL) NCH BONITA AMBULATORY SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
19316$1620.001376556514 - EYE CARE SPECIALISTS PS, THE LASER AND SURGERY CENTER911895676 - (WA) EYECARE SPECIALIST, PSWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
19316$1750.001487122669 - CONWAY CARDIOVASCULAR SURGERY CENTER, LLC832435695 - (AR) CONWAY CARDIOVASCULAR SURGERY CENTER LLCARAmbulatory Surgical Clinic/Center (261QA1903X)
United
19316$3570.001336142413 - TEXAN AMBULATORY SURGERY CENTER, LP331058382TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
19316$1423.001770645905 - SILVER SPRING MD ENDOSCOPY ASC LLC, ENDOSCOPIC SURGICAL CENTRE OF MARYLAND205988845 - (MD) SILVER SPRING MD ENDOSCOPY ASC LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
19316$2700.001588312607 - JEWETT ORTHOPEDIC INSTITUTE SURGERY CENTER, LLC872667237 - (FL) JEWETT ORTHOPEDIC INSTITUTE SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
19316$1672.001578593224 - K S MANAGEMENT SERVICES LLC, KELSEY-SEYBOLD ASC842241460TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
19316$733.001578600979 - HOTCHKISS AND KATZEN AMBULATORY SURGICAL CENTER, METRO AMBULATORY SURGICAL CENTER522048920 - (MD) HOTCHKISS AND KATZEN AMBULATORY SURGICAL CENTERMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
19316$2280.001386647402 - PHYSICIANS DAY SURGERY CENTER, LLC, PHYSICIANS DAY SURGERY CENTER, INC.593438026 - (FL) PHYSICIANS DAY SURGERY CENTER, INC.FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
19316$2307.001477503175 - PALMS WEST SURGERY CENTER LTD201008459 - (FL) PALMS WEST SURGERY CENTER LTDFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
19316$1505.001194291401 - AFFILIATED PHYSICIANS & SURGEONS, LTD860495569 - (AZ) AFFILIATED PHYSICIANS SURGEONS LTDAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 19316 vs. Other Surgical Procedures on the Integumentary System Codes

The CPT 19316 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 19316 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
19316-CPTHighMastopexy
19318-CPTHighBreast Reduction (Desc Rvsd 1/1/21)
19340-CPTModerateInsertion Of Breast Implant On Same Day Of Mastectomy (Ie Immediate) (Desc Rvsd 1/1/21)
19350-CPTHighReconstruct Nipple/Areolar Unil

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 19316. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 19316 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules


Medicare & Medicaid Rates

Government-set reimbursement amounts


Private Insurance Rates

Negotiated rates between providers and insurance companies


Geographic Location

Costs may be higher in urban areas.


Provider Type

Hospital providers may have different rates than private practice.

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