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See a sample rate comparisonCPT 19340 Fee Schedule
Last Verified: October 2026
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.
Immediate Insertion Of Breast, Immediate Insertion Of Breast Prosthesis Followingmastopexy Mastectomy Or In Reconstruction Immediate Insertion Of Breast Prosthesis Following
| 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 LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 19340 |
| Medicaid Fee Schedule | View Medicaid rates for 19340 |
National average reimbursement for CPT 19340 by major payers:
$979.64
$1,105.37
$1,111.70
$1,275.25
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CPT 19340
5 of 25 sample ratesHigher to lower in this preview
Providence Surgery Centers LLC, Creekside Surgical Center
Providence Surgery Centers LLC Dba Creekside Surgery Center
$6,763.00Published rateAffiliated Endoscopy Services Of Clifton LLC, Affiliated Endoscopy Services Of Clifton
Affiliated Endoscopy Services Of Clifton LLC
$4,839.00Published rateE Street Endoscopy LLC, West Coast Endoscopy
E Street Endoscopy
$3,275.00Published rateWest Side Gi, LLC
Westside Gi Center, LLC
$2,436.00Published ratePrince Georges Multi Specialty Surgery Center
$953.00Published rate
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See a sample payer proposalCPT 19340 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19340 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 19340 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 |
|---|---|---|
| 19301-CPT | Moderate | Removal Of Part Of A Breast, Surgery To Remove A Single Lump Or A Portion Of The Breast Tissue (Partial Mastectomy). Nearby Lymph Nodes Also May Be Removed. |
| 19330-CPT | Moderate | Removal Of Ruptured Breast Implnt Incl Implnt Cont, Removal Of Ruptured Breast Implant Incl Implant Contents (Eg Saline Silicone Gel) |
| 19340-CPT | Moderate | Immediate Insertion Of Breast, Immediate Insertion Of Breast Prosthesis Followingmastopexy Mastectomy Or In Reconstruction Immediate Insertion Of Breast Prosthesis Following |
| 19342-CPT | High | Delayed Insertion Of Breast Pr, Delayed Insertion Of Breast Prosthesis Following Mastopexy Mastectomy Or In Reconstruction Delayedinsertion Of Breast Prosthesis Following Mastopex Y |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 19340. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19340 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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