Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 19350 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.
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.
| 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
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 19350.
CPT 19350
5 of 25 sample ratesHigher to lower in this preview
Medical Center Surgery Associates, Lp
Medical Center Surgery Associates Lp
$6,651.00Published rateNorthwest Surgery Center, LLP, Northwest Surgery Center
Northwest Surgery Center LLP
$2,353.00Published rateGeorgia Urology, PA, Ga Urology Asc Roswell
$1,647.00Published rateBethesda Outpatient Surgery Center LLC, Palm Beach Outpatient Surgery Center
Bethesda Outpatient Surgery Center LLC
$1,129.00Published rateWashburn Surgery Center, LLC
Washburn Surgery Center LLC
$505.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 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 |
|---|---|---|
| 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 |
| 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 |
| 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 19350) and we'll show you how you compare in 15 minutes or less.