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See a sample rate comparisonCPT 19355 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.
Nipple Corrective Surgery, Surgery To Correct An Inverted Nipple Including Redirecting Ducts And Supporting Tissue.
| 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 | Moderate |
| Medicare Fee Schedule | View Medicare rates for 19355 |
| Medicaid Fee Schedule | View Medicaid rates for 19355 |
National average reimbursement for CPT 19355 by major payers:
$920.07
$948.79
$952.74
$997.49
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CPT 19355
5 of 25 sample ratesHigher to lower in this preview
Columbia Medical Center Of Plano Subsidiary Lp, Medical City Plano
$10,081.00Published rateMinimally Invasive Surgery Center Of N.E., LLC
$4,339.00Published rateProcedure Center Of Irvine Inc., Procedure Center Of Irvine
Procedure Center Of Irvine Inc
$2,180.00Published rateVista Surgery Center LLC
$1,735.00Published rateDigestive Health & Endoscopy Center LLC
$518.00Published rate
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See a sample payer proposalCPT 19355 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19355 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 19355 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 |
|---|---|---|
| 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. |
| 19355-CPT | Moderate | Nipple Corrective Surgery, Surgery To Correct An Inverted Nipple Including Redirecting Ducts And Supporting Tissue. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 19355. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19355 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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