CPT 19357 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 • 21 - Inpatient Hospital |
| Common Modifiers | • None • 50 - Bilateral Procedure • RT - Right side of body |
| Complexity Level | High |
National average reimbursement for CPT 19357 by major payers:
$1,629.16
$1,917.32
$1,824.44
$2,174.56
| 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 19357 | ||||||
United | 19357 | $5250.00 | 1174530752 - LAKE MARY SURGERY CENTER LLC | 134215228 - (FL) LAKE MARY SURGERY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19357 | $4309.00 | 1316379647 - MINNESOTA EYE LASER & SURGERY CENTERS, LLC, MINNESOTA EYE LASER & SURGERY CENTERS | 460505033 - (MN) MINNESOTA EYE LASER SURGERY CENTERS LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19357 | $1323.00 | 1922486679 - ST LOUIS SPECIALTY SURGICAL CENTER, LLC | 611754451 - (MO) ST LOUIS SPECIALTY SURGICAL CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19357 | $3405.00 | 1346912250 - SOUTHEAST EYE LASER SURGERY CENTER | 853785035 - (GA) SOUTHEAST EYE LASER SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19357 | $6588.00 | 1821036138 - GAMMA SURGERY CENTER LLC | 270128900 - (PA) GAMMA SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19357 | $5846.00 | 1154911592 - BCC WEST VALLEY LLC | 854264663 - (AZ) BCC WEST VALLEY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19357 | $680.00 | 1790822864 - NORTHWEST EYE SPECIALISTS,LLC | 860720868 - (AZ) NORTHWEST EYE SPECIALISTS, P.L.L.C. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19357 | $1496.00 | 1407223019 - VALLEY OUTPATIENT SERVICES, LLC | 474866031 | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19357 | $1911.00 | 1013096700 - CLEARER VISION, LLC, PERIMETER SURGERY CENTER | 621792483 - (TN) CLEARER VISION, LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19357 | $835.00 | 1548359037 - SURGERY CENTER OF BRANSON, SURGERY CENTER OF BRANSON LLC | 680627781 - (MO) SURGERY CENTER OF BRANSON | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19357 | $5653.00 | 1780689802 - PAIN DIAGNOSTIC AND TREATMENT CENTER LP | 770525632 - (CA) PAIN DIAGNOSTIC AND TREATMENT CENTER, LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19357 | $668.00 | 1184666364 - LONG ISLAND CENTER FOR DIGESTIVE HEALTH LLC | 364444162 - (NY) LONG ISLAND CENTER FOR DIGESTIVE HEALTH, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19357 | $6087.00 | 1407275282 - SURGCENTER CAMELBACK LLC | 464169482 - (AZ) SURGCENTER CAMELBACK LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19357 | $2056.00 | 1164597761 - OUTPATIENT EYE SURGERY CENTER | 721098835 - (LA) OUTPATIENT EYE SURGERY CENTER | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19357 | $9100.00 | 1164513149 - ENDO-SURGI OF UNION ASC LLC | 223248249 - (NJ) ENDO-SURGI CENTER, P.A. | NJ | 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 19357 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19357 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 19357 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 |
|---|---|---|
| 19296-CPT | High | Placement Of Radiotherapy Afterloading Expandable Catheter (Single Or Multichannel) Into The Breast For Interstitial Radioelement Application Following Partial Mastectomy, Includes Imaging Guidance; On Date Separate From Partial Mastectomy |
| 19297-CPT | Low | Placement Of Radiotherapy Afterloading Expandable Catheter (Single Or Multichannel) Into The Breast For Interstitial Radioelement Application Following Partial Mastectomy, Includes Imaging Guidance; Concurrent With Partial Mastectomy (List Separately In Addition To |
| 19301-CPT | Moderate | Mastectomy, Partial (E.G. Lumpectomy, Tylectomy, Quandrantectomy, Segmentectomy) |
| 19357-CPT | High | Tissue Expander Placement In Breast Reconstruction Including Subsequent Expansion(S) (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 19357. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19357 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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