CPT 19364 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 | • 50 - Bilateral Procedure • None • 62 - Co-Surgeons |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 19364 |
National average reimbursement for CPT 19364 by major payers:
$4,384.15
$3,617.49
$4,139.37
$4,583.65
| 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 19364 | ||||||
United | 19364 | $2814.00 | 1134785389 - CEI PHYSICIANS PSC, LLC, CVP SURGERY CENTER | 311473421 - CINCINNATI EYE INSTITUTE | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19364 | $8238.00 | 1609831700 - SURGICAL CAREGIVERS OF FORT WORTH LLC, TEXAS HEALTH SURGERY CENTER FORT WORTH MIDTOWN | 751925497 - (TX) SURGICAL CAREGIVERS OF FORT WORTH LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19364 | $5249.00 | 1194913574 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19364 | $3200.00 | 1629222815 - GEORGIA UROLOGY, PA, GEORGIA UROLOGY ASC CONYERS | 550846177 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19364 | $2931.00 | 1700263415 - NORTH POINT SURGERY CENTER, LLC | 464488421 - (MO) NORTH POINT SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19364 | $3275.00 | 1336445873 - SAND LAKE SURGICENTER LLC, SAND LAKE SURGERY CENTER | 273787593 - (FL) SAND LAKE SURGICENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19364 | $518.00 | 1003858721 - PIEDMONT ENDOSCOPY CENTER, INC. | 561634105 | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19364 | $5433.00 | 1295479780 - ADVENTHEALTH SURGERY CENTER DAVENPORT LLC | 881811228 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19364 | $3968.00 | 1407836315 - SPINE CARE DELAWARE, LLC | 510393046 - (DE) SPINE CARE DELAWARE LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19364 | $3340.00 | 1164513149 - ENDO-SURGI OF UNION ASC LLC | 223248249 - (NJ) ENDO-SURGI CENTER, P.A. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19364 | $875.00 | 1407828494 - INDEPENDENCE ASC LLC, THE ENDOSCOPY CENTER - EAST | 621707564 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19364 | $2216.13 | 1225369440 - PHILLIP MARTIN | 350593390 - DEACONESS HOSPITAL INC | TN | Certified Registered Nurse Anesthetist (367500000X) |
United | 19364 | $4553.00 | 1144948167 - MCALLEN SURGICENTER, LLC, MCALLEN SURGERY CENTER | 862290088 - (TX) MCALLEN SURGICENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19364 | $2000.00 | 1588994685 - SOUTHEASTERN INTERVENTIONAL PAIN ASC LLC | 271651377 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19364 | $2661.00 | 1295988731 - BAPTIST EASTPOINT SURGERY CENTER, LLC | 610444707 - BAPTIST HEALTHCARE SYSTEM INC | KY | 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 19364 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19364 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 19364 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 |
|---|---|---|
| 19298-CPT | High | Placement Of Radiotherapy Afterloading Brachy- Therapy Catheter (Multiple Tube And Button Type) Into The Breast For Interstitial Radioelement Application Following (At The Time Of Or Subse- Quent To) Partial Mastectomy Includes Imaging Guidance |
| 19364-CPT | High | Breast Reconstruction; With Free Flap (Eg Ftram Diep Siea Gap Flap) (Desc Rvsd 1/1/21) |
| 19367-CPT | High | Breast Reconstruction; With Single-Pedicled Transverse Rectus Abdominis Myocutaneous (Tram) Flap (Desc Rvsd 1/1/21) |
| 19368-CPT | High | Breast Reconstruction; With Single-Pedicled Transverse Rectus Abdominis Myocutaneous (Tram) Flap Requiring Separate Microvascular Anastomosis (Supercharging) (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 19364. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19364 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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