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See a sample rate comparisonCPT 19357 Fee Schedule
Last Verified: September 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 21 - Inpatient Hospital |
| Common Modifiers | None 50 - Bilateral Procedure RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 19357 |
| Medicaid Fee Schedule | View Medicaid rates for 19357 |
National average reimbursement for CPT 19357 by major payers:
$1,629.16
$1,917.32
$1,824.44
$2,117.11
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CPT 19357
5 of 25 sample ratesHigher to lower in this preview
Aurora Gi Asc LLC, Wisconsin Digestive Health Center
Aurora Gi Asc LLC
$14,053.00Published rateSjv Management, LLC, South Jersey Vascular Surgery Center
Sjv Management, LLC
$5,127.00Published rateWellness Ambulatory Surgery Center, LLC
Wellness Ambulatory Surgery Center LLC
$3,500.00Published rateMercy Catholic Medical Center Of Southeastern PA, Mercy Philadelphia Hospital Short Procedure Unit
Mercy Catholic Medical Center Of Southeastern PA
$2,499.00Published rateNorthwest Eye Specialists,LLC
Northwest Eye Specialists, P.L.L.C.
$680.00Published rate
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See a sample payer proposalCPT 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 |
|---|---|---|
| 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. |
| 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 |
| 19357-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. |
| 19371-CPT | Moderate | 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 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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