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See a sample rate comparisonCPT 19316 Fee Schedule
Last Verified: October 2026
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.
Cosmetic Breast Lift, Cosmetic Surgery To Remove Excess Tissue And Shorten Muscles So That Breasts Move To A Higher Position On The Chest.
| Key Fact | Detail |
|---|---|
| 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 Level | High |
| Medicare Fee Schedule | View Medicare rates for 19316 |
| Medicaid Fee Schedule | View Medicaid rates for 19316 |
National average reimbursement for CPT 19316 by major payers:
$1,040.29
$1,008.18
$1,067.47
$1,280.14
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CPT 19316
5 of 25 sample ratesHigher to lower in this preview
Surgery Center Of Southwest Ohio, LLC, The Surgery Center Of Southwest Ohio
The Surgery Center Of Southwest
$8,653.00Published ratePortland Clinic, The Portland Clinic Surgical Center
The Portland Clinic LLP
$2,800.00Published rateEast Jefferson Ambulatory Surgery Center
East Jefferson Ambulatory
$1,672.00Published rateSurgical Specialty Center Of Northeastern Pennsylvania, LLC
Surgical Specialty Center Of N
$1,305.00Published rateHoliday Surgery Center Limited Partnership L L P
$455.00Published rate
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See a sample payer proposalCPT 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.
| Code | Complexity | Description |
|---|---|---|
| 19316-CPT | High | Cosmetic Breast Lift, Cosmetic Surgery To Remove Excess Tissue And Shorten Muscles So That Breasts Move To A Higher Position On The Chest. |
| 19318-CPT | High | Breast Reduction, Surgery In Which Tissue Is Removed To Reduce The Size Of The Breasts (Reduction Mammaplasty). |
| 19340-CPT | Moderate | Immediate Insertion Of Breast, Immediate Insertion Of Breast Prosthesis Followingmastopexy Mastectomy Or In Reconstruction Immediate Insertion Of Breast Prosthesis Following |
| 19350-CPT | High | Breast Reconstruction, Surgery To Reconstruct A Breast Or Nipple After A Mastectomy. The Procedure May Use Tissue Expanders Implants Skin Or Muscle Flaps Or Other Reconstructive Devices. Additional Procedures May Be Needed To Achieve The Desired Size Or Shape. |
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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