CPT 19361 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 19361 |
National average reimbursement for CPT 19361 by major payers:
$2,098.44
$2,037.19
$2,117.68
$2,589.58
| 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 19361 | ||||||
United | 19361 | $425.00 | 1972156842 - NORMAN REGIONAL HOSPITAL AUTHORITY, MEDICAL PLAZA ENDOSCOPY | 736048282 | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19361 | $1147.00 | 1780689802 - PAIN DIAGNOSTIC AND TREATMENT CENTER LP | 770525632 - (CA) PAIN DIAGNOSTIC AND TREATMENT CENTER, LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19361 | $163.00 | 1003887225 - CENTRAL TEXAS ENDOSCOPY CENTER LLC, CENTRAL TEXAS ENDOSCOPY CENTER | 742863853 - (TX) CENTRAL TEXAS ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19361 | $983.00 | 1104298009 - RED CEDAR SURGERY CENTER, LLC, RED CEDAR SURGERY CENTER, PLLC | 472947364 - (MI) RED CEDAR SURGERY CENTER, PLLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19361 | $1073.00 | 1740681733 - SURGCENTER OF GREATER PHOENIX, LLC | 465683789 - (AZ) SURGCENTER OF GREATER PHOENIX LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19361 | $132.00 | 1336143148 - MARIN OPHTHALMIC SURGERY CENTER | 680297790 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19361 | $725.00 | 1902213432 - COBBLESTONE SURGERY CENTER, INC. | 464241477 - (GA) COBBLESTONE SURGERY CENTER INC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19361 | $950.00 | 1326309394 - ADVANCED SURGERY CENTER OF ORLANDO LLC | 453785008 - (FL) ADVANCED SURGERY CENTER OF ORLANDO LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19361 | $371.00 | 1437232758 - SHADY GROVE REPRODUCTIVE SCIENCE CENTER PC, SGFC SURGERY CENTER | 208131466 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19361 | $600.00 | 1194970418 - PACIFIC CATARACT AND LASER INSTITUTE INC PC | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19361 | $1064.00 | 1053764779 - SURGCENTER OF ST. LUCIE, LLC | 475425011 - (FL) SURGCENTER OF ST. LUCIE, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19361 | $341.00 | 1083920151 - HILLMOOR EYE SURGERY CENTER, LLC, ONE DAY SURGERY | 273127763 - (FL) HILLMOOR EYE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19361 | $2375.00 | 1164811923 - SHRINERS HOSPITALS FOR CHILDREN, SHRINERS HOSPITALS FOR CHILDREN AMBULATORY SURGERY CENTER-LEXINGTON | 362193608 - SHRINERS HOSPITALS FOR CHILDREN | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19361 | $1608.00 | 1831576891 - ADVANCED SURGERY CENTER PERIMETER, LLC | 473080613 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19361 | $1000.00 | 1740337435 - DIAGNOSTIC AND INTERVENTIONAL SURGICAL CENTER, DIAGNOSTIC AND INTERVENTIONAL SURGICAL CENTER | 342064423 - (CA) DIAGNOSTIC AND INTERVENTIONAL SURGERY CENTER, LLC | CA | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 19361 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19361 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 19361 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 |
| 19357-CPT | High | Tissue Expander Placement In Breast Reconstruction Including Subsequent Expansion(S) (Desc Rvsd 1/1/21) |
| 19361-CPT | High | Breast Reconstruction With Latissimus Dorsi Flap, Without Prosthetic Implan |
| 19364-CPT | High | Breast Reconstruction; With Free Flap (Eg Ftram Diep Siea Gap Flap) (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 19361. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19361 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 19361) and we'll show you how you compare in 15 minutes or less.