CPT 19370 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 50 - Bilateral Procedure • RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 19370 |
National average reimbursement for CPT 19370 by major payers:
$889.40
$882.42
$913.45
$1,123.33
| 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 19370 | ||||||
United | 19370 | $2415.00 | 1356773584 - SURGERY CENTER OF MUNSTER, LLC, THE CENTER FOR MINIMALLY INVASIVE SURGERY | 461961043 - (IN) SURGERY CENTER OF MUNSTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19370 | $3347.00 | 1871751859 - WESTMINSTER SURGERY CENTER | 262059600 - (MD) WESTMINSTER SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19370 | $705.00 | 1447457403 - BERGEN GASTROENTEROLOGY PC | 222713168 - (NJ) BERGEN GASTROENTEROLOGY, P.C. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19370 | $3353.00 | 1447364682 - RIDGE VIEW ENDOSCOPY CENTER | 800688043 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19370 | $2200.00 | 1871519314 - NORTHERN LITHO INC | 161511455 - (FL) NORTHERN LITHO, INC. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19370 | $2186.00 | 1043819873 - LONE TREE SURGERY CENTER, LLC | 851321160 - (CO) LONE TREE SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19370 | $1700.00 | 1851491013 - NEW ENGLAND AMBULATORY SURGICENTER, LLC | 205110715 - (MA) NEW ENGLAND AMBULATORY SURGICENTER LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19370 | $3353.00 | 1336790237 - AURORA ENDOSCOPY SURGICENTER, LLC | 825396997 - (CO) AURORA ENDOSCOPY SURGICENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19370 | $2780.00 | 1942722798 - DREXEL TOWN SQUARE SURGERY CENTER, LLC, DREXEL TOWN SQUARE SURGERY CENTER | 814904300 - (WI) DREXEL TOWN SQUARE SURGERY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19370 | $3400.00 | 1730296997 - DAY SURGERY LIMITED LIABILITY | 550737750 - (WV) DAY SURGERY LLC | WV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19370 | $2200.00 | 1619926755 - EYE SURGERY CTR OF SO CALIF A MED GROUP, TRI-CITY SURGERY CENTER | 953856768 - (CA) EYE SURGERY CTR OF SO CALIF A MED GROUP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19370 | $1900.00 | 1841955358 - ADVENTIST HEALTHCARE SC AT NATIONAL HARBOR, LLC | 852814304 - (MD) ADVENTIST HEALTHCARE SC AT NATIONAL HARBOR LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19370 | $1142.00 | 1740448711 - TREVOSE SPECIALTY CARE SURGICAL CENTER, LLC | 262420083 - (PA) TREVOSE SPECIALTY CARE SURGICAL CENTER, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19370 | $1500.00 | 1821560434 - SUNSET PAIN SURGERY CENTER | 832872516 - (NV) SUNSET PAIN SURGERY CENTER | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 19370 | $3570.00 | 1659517019 - SURGERY CENTER OF PEMBROKE PINES, LLC | 263364068 - (FL) SURGERY CENTER OF PEMBROKE | FL | 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 19370 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19370 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 19370 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 |
|---|---|---|
| 19357-CPT | High | Tissue Expander Placement In Breast Reconstruction Including Subsequent Expansion(S) (Desc Rvsd 1/1/21) |
| 19364-CPT | High | Breast Reconstruction; With Free Flap (Eg Ftram Diep Siea Gap Flap) (Desc Rvsd 1/1/21) |
| 19369-CPT | High | Breast Reconstruction; With Bipedicled Transverse Rectus Abdominis Myocutaneous (Tram) Flap (Desc Rvsd 1/1/21) |
| 19370-CPT | Moderate | Revision Of Peri-Implant Capsule Breast Including Capsulotomy Capsulorrhaphy And/Or Partial Capsulectomy (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 19370. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19370 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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