Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 19396 Fee Schedule
Last Verified: October 2026
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.
Preparation Moulage Breast Implant
| 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 LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 19396 |
| Medicaid Fee Schedule | View Medicaid rates for 19396 |
National average reimbursement for CPT 19396 by major payers:
$315.03
$341.46
$340.31
$253.75
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 19396.
CPT 19396
5 of 25 sample ratesHigher to lower in this preview
Aurora Surgery Centers, LLC, Aurora Pleasant Prairie Ambulatory Surgery Center
Aurora Surgery Centers LLC
$9,270.00Published rateMiddle Tennessee Ambulatory Surgery Center, L.P.
Middle Tennessee Ambulatory Surgery Center Lp
$4,339.00Published rateOcean Endosurgery Center LLC, Ocean Endosurgery Center
Ocean Endosurgery Center LLC
$2,795.00Published rateMoses Cone Medical Services Inc., Lebauer Endoscopy Center
Moses Cone Medical Services Inc
$1,427.00Published rateCarlos Giammattei
Deaconess Hospital Inc
$502.66Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 19396 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 19396 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 19396 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 |
|---|---|---|
| 19350-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. |
| 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. |
| 19367-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. |
| 19396-CPT | Moderate | Preparation Moulage Breast Implant |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 19396. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 19396 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 19396) and we'll show you how you compare in 15 minutes or less.