CPT 19368 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 | • 62 - Co-Surgeons • None • 50 - Bilateral Procedure |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 19368 |
National average reimbursement for CPT 19368 by major payers:
$2,949.75
$2,869.44
$2,814.75
$3,625.58
| 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 19368 | ||||||
United | 19368 | $2790.00 | 1124484019 - EDISON SURGERY CENTER LLC | 475016492 - (NJ) EDISON SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $6506.00 | 1588867030 - PACIFIC ENDO-SURGICAL CENTER LP | 562387275 - (CA) PACIFIC ENDOSURGICAL CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $2800.00 | 1194326785 - TEXAS PARTNERS CENTER LLC | 853236752 - (TX) TEXAS PARTNERS CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $1600.00 | 1871596114 - NORTHERN ARIZONA SURGICENTER, LLC | 860747413 - (AZ) NORTHERN ARIZONA SURGICENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $1742.00 | 1487090452 - DIGESTIVE HEALTH SPECIALISTS, PA | 561242980 - (NC) DIGESTIVE HEALTH SPECIALISTS, P.A. | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $1343.00 | 1477628725 - SURGERY & LASER CENTER AT PROFESSIONAL PARK LLC, SURGERY & LASER CENTER AT PROFESSIONAL PARK LLC | 202435770 - (SC) SURGERY LASER CENTER AT PROFESSIONAL PARK LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $5354.00 | 1174778047 - RSC ILLINOIS LLC, REGIONAL SURGICENTER | 261363389 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $811.00 | 1689646937 - OCALA ENDOSCOPY ASC LP, ENDOSCOPY CENTER OF OCALA | 621650750 - (FL) OCALA ENDOSCOPY ASC LP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $5433.00 | 1770929044 - SURGCENTER OF PALM BEACH GARDENS, SURGCENTER OF PALM BEACH GARDENS, LLC | 462315994 - (FL) SURGCENTER OF PALM BEACH GARDENS, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $5433.00 | 1326453325 - CAPITAL CITY SURGERY CENTER OF FLORIDA LLC | 471211202 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $5354.00 | 1730318353 - GARDENDALE SURGICAL ASSOCIATES, LLC | 205936644 - (AL) GARDENDALE SURGICAL ASSOCIATES | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $7319.00 | 1922075167 - NORTH CENTRAL METHODIST ASC, LP, METHODIST AMBULATORY SURGERY CENTER NORTH CENTRAL | 742998447 - (TX) NORTH CENTRAL METHODIST ASC LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $2019.00 | 1821279720 - NEW ORLEANS LA UPTOWN WEST BANK ENDOSCOPY ASC LLC, MGA GASTROINTESTINAL DIAGNOSTIC AND THERAPEUTIC CENTER | 205904530 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $3792.00 | 1518311141 - THE REGENTS OF THE UNIVERSITY OF CALIFORNIA, UCLA DEPT OF MEDICINE | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $2024.00 | 1750668190 - ELKHART DAY SURGERY, LLC, INSIGHT SURGERY CENTER | 800712220 - (IN) ELKHART DAY SURGERY LLC | IN | 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 19368 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19368 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 19368 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 |
|---|---|---|
| 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) |
| 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 19368. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19368 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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