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See a sample rate comparisonCPT 19371 Fee Schedule
Medicare rates as of October 2026
CPT 19371 is classified under Surgery, in the Surgical Procedures on the Integumentary System subgroup.
Breast Reconstruction, Surgery To Reconstruct A Breast Or Nipple After A Mastectomy. The Procedure May Use Tissue Expanders Implants Skin Or Muscle Flaps Or Other Reconstructive Devices. Additional Procedures May Be Needed To Achieve The Desired Size Or Shape.
| 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 | 50 - Bilateral Procedure RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $649.31 national non-facility rate (2026) · View Medicare rates for 19371 |
| Medicaid Fee Schedule | $513.325 median of the 8 states in the free preview · View Medicaid rates for 19371 |
National average reimbursement for CPT 19371 by major payers:
$979.69
BCBS / Anthem
$1,008.07
UnitedHealthcare
$1,025.15
Aetna
$1,201.64
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 19371.
CPT 19371
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Memorial City LLC, Memorial Hermann Memorial Village Surgery Center
$7,838.00Published rateGastroenterology Associates, LLC, Gastroenterology Associates Endoscopy Center
Gastroenterology Associates PLLC
$3,570.00Published rateNorthwest Surgery Center, LLC
Lewis & Clark Orthopaedic, LLC 401(K) Plan
$2,076.00Published rate20-20 Surgery Center LLC
2020 Surgery Center LLC
$1,300.00Published ratePain-Mds Ambulatory Surgical Center, LLC
Painmds Ambulatory Surgical Center LLC
$543.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 19371 vs. Other Surgical Procedures on the Integumentary System Codes
The table lists codes related to 19371. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 19298-CPT | High | Place Breast Rad Tube Caths, Placement Of Radiotherapy After Loading Brachytherapy Catheters Multiple Tube And Button Type Into The Breast For Interstitial Radioelement Application Following At The Time Of Or Subsequent To Partial Mastectomy Includes Imaging Guidance |
| 19357-CPT | High | Breast Reconstruction, Surgery To Reconstruct A Breast Or Nipple After A Mastectomy. The Procedure May Use Tissue Expanders Implants Skin Or Muscle Flaps Or Other Reconstructive Devices. Additional Procedures May Be Needed To Achieve The Desired Size Or Shape. |
| 19370-CPT | Moderate | Breast Reconstruction, Surgery To Reconstruct A Breast Or Nipple After A Mastectomy. The Procedure May Use Tissue Expanders Implants Skin Or Muscle Flaps Or Other Reconstructive Devices. Additional Procedures May Be Needed To Achieve The Desired Size Or Shape. |
| 19371-CPT | Moderate | Breast Reconstruction, Surgery To Reconstruct A Breast Or Nipple After A Mastectomy. The Procedure May Use Tissue Expanders Implants Skin Or Muscle Flaps Or Other Reconstructive Devices. Additional Procedures May Be Needed To Achieve The Desired Size Or Shape. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 19371. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19371 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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Frequently Asked Questions
To find out the cost of a medical procedure or service, you generally need to know the specific service (often identified by a CPT code) and the location where you plan to receive care. Tools like Payerprice can help you research these costs.
A CPT (Current Procedural Terminology) code is a five-digit numerical code used by healthcare providers to describe medical, surgical, and diagnostic services. It's crucial for pricing because it standardizes the identification of services, allowing you to accurately look up costs for specific procedures.
Yes, the price of healthcare services can vary significantly based on your specific location. Factors like local cost of living, regional market competition, and facility type all contribute to pricing differences. When searching for costs, always include your specific location for the most relevant results.
For specific pricing information based on CPT codes and your location, it's recommended to use tools designed for this purpose. Payerprice offers a fee schedule lookup tool that allows users to search with a CPT code and specific location to find relevant pricing data.
To effectively use a tool like Payerprice, you will typically need the specific CPT code for the medical procedure or service you are interested in, and your specific geographic location (e.g., zip code or city and state). This information allows the tool to provide localized and accurate fee schedule data.