CPT 19325 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| 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 • 50 - Bilateral Procedure • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 19325 by major payers:
$837.61
$833.33
$867.80
$1,051.85
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 19325 | ||||||
United | 19325 | $6492.00 | 1275870537 - GCSA AMBULATORY SURGERY CENTER, LLC | 611699459 - (TX) GCSA AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19325 | $1495.00 | 1447271713 - COLUMBUS ORTHOPEDIC OUTPATIENT | 900069344 - (MS) COLUMBUS ORTHOPEDIC OUTPATIENT | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19325 | $624.00 | 1639149255 - COLD SPRINGS MEDICAL SURGICAL GROUP LLC, DE LA VINA SURGICENTER | 770521530 - (CA) COLD SPRINGS MEDICAL SURGICAL GROUP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19325 | $6365.00 | 1063947422 - SILVER CROSS AMBULATORY SURGERY CENTER, LLC, SILVER CROSS SURGERY CENTER | 371852055 - (IL) SILVER CROSS AMBULATORY SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19325 | $4650.00 | 1649922485 - NORTHERN LAKES SURGERY CENTER LLC | 874431494 - (MN) NORTHERN LAKES SURGERY CENTER LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19325 | $9182.00 | 1124492541 - MEMORIAL HERMANN SURGERY CENTER PINECROFT, LLC | 371796296 - (TX) MEMORIAL HERMANN SURGERY CENTER PINECROFT LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19325 | $6342.00 | 1083785398 - OLYMPIA ORTHOPAEDIC ASSOCIATES PLLC, OLYMPIA SURGERY CENTER LLC | 911674528 - OLYMPIA ORTHOPAEDIC ASSOCIATES, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19325 | $860.00 | 1891406328 - CEI PHYSICIANS PSC, LLC | 311473421 - CINCINNATI EYE INSTITUTE | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19325 | $7888.00 | 1992827992 - ATHERTON PLASTIC SURGERY CENTER | 460842370 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19325 | $1904.00 | 1316976137 - CENTRAL MARYLAND ENDOSCOPY LLC | 201580201 - (MD) CENTRAL MARYLAND ENDOSCOPY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19325 | $3861.00 | 1982641064 - PIONEER VALLEY SURGICENTER LLC, PIONEER VALLEY SURGICENTER | 10740204 - (MA) PIONEER VALLEY SURGICENTER, LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19325 | $3449.00 | 1093449225 - NARROWS SURGERY CENTER PS | 43700768 - (WA) EYE M.D.S OF PUGET SOUND, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19325 | $2861.00 | 1043984248 - NORTHERN OHIO SURGERY CENTER, LLC | 871114330 - (OH) NORTHERN OHIO SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19325 | $833.00 | 1225070527 - LIBERTY CATARACT CENTER LLC | 743099283 - (MO) LIBERTY CATARACT CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19325 | $5040.00 | 1376228361 - SPRINGFIELD REGIONAL OUTPATIENT SURGERY CENTER LLC | 923802390 - (OH) SPRINGFIELD REGIONAL OUTPATIENT SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 19325 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19325 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 19325 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 |
|---|---|---|
| 19318-CPT | High | Breast Reduction (Desc Rvsd 1/1/21) |
| 19325-CPT | Moderate | Breast Augmentation With Implant (Desc Rvsd 1/1/21) |
| 19328-CPT | Moderate | Removal Of Intact Breast Implant (Desc Rvsd 1/1/21) |
| 19340-CPT | Moderate | Insertion Of Breast Implant On Same Day Of Mastectomy (Ie Immediate) (Desc Rvsd 1/1/21) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 19325. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19325 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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