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CPT code 19325: Breast augmentation, prosthetic implant placement2026 Medicare rate & RVUs

Breast augmentation with an implant increases breast volume; report it for implant placement performed for augmentation rather than postmastectomy reconstruction.

CMS RVU26DEffective Oct 1, 2026109 payment localities732 Medicare services in 2024

Medicare pays $566.15 for 19325 nationally in a facility.

Medicare rate · 19325

Breast augmentation, prosthetic implant placement

Office or facility?

Work RVUs
7.92
Total RVUs
16.95
Global days
090

National rate · 2026

$566.15

Facility setting, before claim adjustments.

See every locality for 19325 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 19325 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 19325 covers

This operation increases breast volume by placing a prosthetic implant in the breast. A plastic surgeon typically performs it in a hospital outpatient department or ambulatory surgery center for a patient seeking enlargement of the breast. It is distinct from implant placement as part of breast reconstruction after mastectomy.

Report the service when the operative record supports implant placement for augmentation, rather than reconstruction or implant removal. CMS assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple procedure reduction. For bilateral augmentation reported with modifier 50, CMS pays at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 19325 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

19325 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$513.17
AlaskaUnavailable$692.61
ArizonaUnavailable$551.21
ArkansasUnavailable$506.61
Atlanta, GAUnavailable$580.91
Austin, TXUnavailable$575.67
Bakersfield, CAUnavailable$576.05
Baltimore area, MDUnavailable$600.50
Beaumont, TXUnavailable$539.94
Brazoria, TXUnavailable$555.12

19325 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
19325 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 19325 rate is calculated

Each of 19325’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 19325

RVUs × geographic indexes × conversion factor

Office or facility?

Work7.92

7.92 RVUs× 1.000 GPCI

Practice expense7.55

7.55 RVUs× 1.000 GPCI

Malpractice1.48

1.48 RVUs× 1.000 GPCI

Adjusted RVUs

16.9500

Conversion factor

$33.4009

Medicare rate

$566.15

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 19325

19325 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 19325

Breast augmentation, prosthetic implant placement

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.71/0.19Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 19325

Breast augmentation, prosthetic implant placement

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

19325 without 50 · national facility

$566.15

Breast augmentation, prosthetic implant placement

19325-50 · Bilateral: 150%

$849.23

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

19325 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 19325

    Breast augmentation, prosthetic implant placement7.92 wRVU

    Not priced

  • 19340

    Breast implant, immediate postmastectomy placement10.22 wRVU

    Not priced

  • 19342

    Breast implant, separate day from mastectomy10.22 wRVU

    Not priced

  • 19316

    Breast lift, ptosis correction10.81 wRVU

    Not priced

  • 19318

    Breast reduction, tissue removal and reshaping15.63 wRVU

    Not priced

How to choose

19340Breast implantImmediate postmastectomy placement
Choose 19340 for implant placement as part of breast reconstruction at the mastectomy, not for augmentation of an intact breast.
19342Breast implantSeparate day from mastectomy
Choose 19342 for implant placement in a separate procedure during breast reconstruction after mastectomy.
19316Breast liftPtosis correction
This code enlarges the breast with an implant; 19316 lifts and reshapes the breast without defining implant augmentation.
19318Breast reductionTissue removal and reshaping
Choose 19318 for breast reduction. This code is for enlargement with an implant.

Codes related to 19325

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 19325
CodeHow it relatesNational office range
Often billed with
19316Breast lift, ptosis correctionMay accompany augmentation when a separate breast lift is also performed.No office rate
Used instead
19340Breast implant, immediate postmastectomy placementUsed for implant placement during breast reconstruction at the mastectomy.No office rate
19342Breast implant, separate day from mastectomyUsed for implant placement during breast reconstruction in a separate, later procedure.No office rate

19325 billing questions

How is this different from implant placement after mastectomy?

This code is for implant placement to enlarge the breast. Codes 19340 and 19342 describe implant placement in breast reconstruction, distinguished by whether placement occurs at the mastectomy or later.

Can a breast lift be reported in the same session?

Code 19316 may be reported when a breast lift is also performed and documented as a separate service. The operative note should describe both the implant augmentation and the lift.

How should bilateral augmentation be reported?

Use modifier 50 for a bilateral procedure. CMS pays bilateral reporting at 150%.

What happens when another procedure is performed during the same session?

Under the standard multiple procedure reduction, CMS pays the highest-valued procedure in full and pays the other procedure or procedures at 50%.

What documentation supports assistant-at-surgery payment?

The record must document the medical necessity of the assistant's participation. CMS does not permit co-surgeons or team surgery for this code.

Which postoperative services are included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 19325PPRRVU2026_Oct_nonQPP.csv, line 1,694 (RVU26D)

Open CMS sourceHow we calculate rates

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