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 |
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 | $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 | $1556.00 | 1164601696 - SALVATORE DIMERCURIO MD PA | 521833726 - (MD) SALVATORE DIMERCURIO, M.D., P.A. | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $9421.00 | 1619995180 - MED CITY DALLAS OUTPATIENT SURGERY CENTER, L.P., MEDICAL CITY SURGERY CENTER/DALLAS | 201043104 | TX | 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 | $5237.00 | 1982672283 - ROSEVILLE SURGERY CENTER, LP, ROSEVILLE SURGERY CENTER | 202468557 - (CA) ROSEVILLE SURGERY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $1230.00 | 1255493482 - GRAYSTONE EYE SURGERY CENTER OF HICKORY, LP, GRAYSTONE EYE SURGERY CENTER | 205740206 | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $3690.00 | 1669465209 - FOUNDATION SURGERY AFFILIATE OF HUNTINGDON VALLEY LP, HUNTINGDON VALLEY SURGERY CENTER | 680499459 - (PA) FOUNDATION SURGERY AFFILIATE OF HUNTINGDON VALLEY | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $3800.00 | 1881850386 - THE CORVALLIS CLINIC PC | 931221257 - (OR) THE CORVALLIS CLINIC, P.C. | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $2629.00 | 1881845907 - NORTH PACIFIC DERMATOLOGY PS | 204269950 - (WA) NORTH PACIFIC DERMATOLOGY PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $4346.50 | 1124022595 - THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS, LLC, SURGERY CENTER CEDAR RAPIDS | 721550812 - (IA) THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $1897.00 | 1477507168 - LAKESIDE SURGERY LLC, LAKESIDE SURGERY CENTER | 752714441 - LAKESIDE SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $1400.00 | 1093295545 - SURGERY CENTER 121 LLC | 831195079 - (TX) SURGERY CENTER 121 LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $1245.00 | 1114951365 - DOCTORS SURGERY CENTER, PA | 710718664 - (AR) DOCTORS SURGERY CENTER PA | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $5611.00 | 1407591902 - AUSTIN GI SURGICENTER, LLC, AUSTIN ENDOSCOPY CENTER | 301073754 - (TX) AUSTIN GI SURGICENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19368 | $1500.00 | 1376641670 - AMBULATORY SURGERY CENTER OF GREATER NEW YORK, LLC | 133418924 - (NY) AMBULATORY SURGERY CENTER OF GREATER NEW YORK, LLC | NY | 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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