CPT 19350 Fee Schedule
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.
| 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 | High |
| Medicare Fee Schedule | View Medicare rates for 19350 |
| Medicaid Fee Schedule | View Medicaid rates for 19350 |
National average reimbursement for CPT 19350 by major payers:
$1,072.96
$1,082.80
$1,141.62
$1,108.00
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 19350 | $1733.00 | 1730783523 - ORTHOARIZONA SCOTTSDALE ASC, LLC | 843527783 - (AZ) ORTHOARIZONA SCOTTSDALE ASC LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19350 | $2564.00 | 1477516961 - CENTRUM SURGERY CENTER LTD | 752546712 - (CO) CENTRUM SURGERY CENTER LTD | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19350 | $800.00 | 1730614330 - GYPSY LANE ENDOSCOPY SUITES, INC. | 475672535 - (OH) GYPSY LANE ENDOSCOPY SUITES INC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19350 | $1647.00 | 1952771230 - GEORGIA UROLOGY, PA, GA UROLOGY ASC ROSWELL | 550846177 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19350 | $1439.67 | 1336128339 - RAJESH PATEL | 350593390 - DEACONESS HOSPITAL INC | IN | Anesthesiology Physician (207L00000X) |
United | 19350 | $800.00 | 1851491013 - NEW ENGLAND AMBULATORY SURGICENTER, LLC | 205110715 - (MA) NEW ENGLAND AMBULATORY SURGICENTER LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19350 | $2859.00 | 1801983556 - TRESANTI SURGICAL CENTER LLC, TRESANTI MEDICAL CORPORATION | 710905694 - (CA) TRESANTI SURGICAL CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19350 | $3348.22 | 1508213810 - ALEGENT CREIGHTON HEALTH, CHI HEALTH AMBULATORY SURGERY CENTER AT MIDLANDS | 470757164 - ALEGENT CREIGHTON HEALTH | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19350 | $2353.00 | 1104974310 - NORTHWEST SURGERY CENTER, LLP, NORTHWEST SURGERY CENTER | 205537270 - (TX) NORTHWEST SURGERY CENTER LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19350 | $505.00 | 1306956818 - WASHBURN SURGERY CENTER, LLC | 752748654 - (KS) WASHBURN SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19350 | $1016.00 | 1306005343 - DIGESTIVE HEALTH SPECIALISTS, PA | 561242980 - (NC) DIGESTIVE HEALTH SPECIALISTS, P.A. | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19350 | $2101.00 | 1548784556 - NORTH ATLANTIC SURGICAL SUITES, LLC | 821540859 - (NH) NORTH ATLANTIC SURGICAL SUITES, LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19350 | $1490.00 | 1104457274 - TEXAS MIDWEST ENDOSCOPY CENTER, LLC | 842574842 - (TX) TEXAS MIDWEST ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19350 | $4141.00 | 1346868890 - UPNT SURGERY LLC | 371939831 - (TX) UPNT SURGERY LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19350 | $1329.00 | 1124197165 - MCALLEN SURGICAL SPECIALTY CENTER LTD | 742952544 - (TX) MCALLEN SURGICAL SPECIALTY CENTER | TX | 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 19350 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19350 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 19350 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 19350. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19350 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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