CPT code 19328: Implant removal, intact implant2026 Medicare rate & RVUs in Puerto Rico
Reports surgical removal of an intact breast implant, such as explantation without rupture or removal during a change in a reconstruction plan.
In Puerto Rico, Medicare pays $515.14 for 19328 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 19328 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 19328 covers
This service is surgical removal of a breast implant that is intact when removed. Plastic surgeons and breast surgeons commonly perform it for explantation or as part of a change in a breast reconstruction plan, in an operating room or another appropriately equipped setting. The operative report should identify the implant and side, confirm its condition, and describe the removal and any capsule work performed.
Choose this code when the implant is intact; use the ruptured-implant code when it is ruptured. Complete periprosthetic capsulectomy has a separate code that includes implant removal, so review the documented capsule work before reporting removal separately. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For bilateral reporting with modifier 50, CMS pays at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment is statutorily restricted; 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.
How Puerto Rico compares for 19328
Across 109 of 109 payment localities, the facility rate for 19328 runs from $459.04 in Arkansas to $628.04 in Alaska. Puerto Rico pays $515.14. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Puerto Rico · this page$515.14
- Los Angeles, CA · California$548.66+$33.52
- Washington, DC area · District of Columbia$571.69+$56.55
- Miami, FL · Florida$594.07+$78.93
- Chicago, IL · Illinois$576.75+$61.61
- Manhattan, NY · New York$592.63+$77.49
- Alaska · Alaska$628.04+$112.90
Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $465.02 |
| ArkansasArkansas | — | $459.04 |
| ArizonaArizona | — | $499.68 |
| Bakersfield, CACalifornia | — | $521.24 |
| Chico, CACalifornia | — | $517.34 |
| El Centro, CACalifornia | — | $517.57 |
| Fresno, CACalifornia | — | $517.34 |
| Hanford, CACalifornia | — | $517.34 |
| Madera, CACalifornia | — | $517.34 |
| Merced, CACalifornia | — | $517.34 |
| Modesto, CACalifornia | — | $517.34 |
| Napa, CACalifornia | — | $577.00 |
| Oxnard, CACalifornia | — | $543.37 |
| Redding, CACalifornia | — | $517.34 |
| Rest of CaliforniaCalifornia | — | $517.34 |
| Riverside, CACalifornia | — | $532.40 |
| Sacramento, CACalifornia | — | $536.98 |
| Salinas, CACalifornia | — | $534.87 |
| San Diego, CACalifornia | — | $543.21 |
| Marin County, CACalifornia | — | $603.11 |
| San Francisco, CACalifornia | — | $601.52 |
| San Benito County, CACalifornia | — | $617.52 |
| Santa Clara County, CACalifornia | — | $611.02 |
| San Luis Obispo, CACalifornia | — | $526.99 |
| Santa Cruz, CACalifornia | — | $545.02 |
| Santa Maria, CACalifornia | — | $535.71 |
| Santa Rosa, CACalifornia | — | $550.11 |
| Stockton, CACalifornia | — | $517.34 |
| Vallejo, CACalifornia | — | $574.71 |
| Visalia, CACalifornia | — | $517.34 |
| Yuba City, CACalifornia | — | $517.34 |
| ColoradoColorado | — | $520.40 |
| ConnecticutConnecticut | — | $545.32 |
| DelawareDelaware | — | $507.17 |
| Fort Lauderdale, FLFlorida | — | $554.07 |
| Rest of FloridaFlorida | — | $527.02 |
| Atlanta, GAGeorgia | — | $527.09 |
| Rest of GeorgiaGeorgia | — | $498.11 |
| Hawaii, Guam, HIHawaii | — | $524.44 |
| IowaIowa | — | $466.10 |
| IdahoIdaho | — | $470.77 |
| East St. Louis, ILIllinois | — | $542.83 |
| Rest of IllinoisIllinois | — | $520.17 |
| Suburban Chicago, ILIllinois | — | $557.23 |
| IndianaIndiana | — | $472.95 |
| KansasKansas | — | $468.63 |
| KentuckyKentucky | — | $484.48 |
| New Orleans, LALouisiana | — | $506.49 |
| Rest of LouisianaLouisiana | — | $485.60 |
| Metropolitan Boston, MAMassachusetts | — | $561.70 |
| Rest of MassachusettsMassachusetts | — | $519.65 |
| Baltimore area, MDMaryland | — | $544.71 |
| Rest of MarylandMaryland | — | $514.65 |
| Rest of MaineMaine | — | $477.74 |
| Southern Maine, MEMaine | — | $494.10 |
| Detroit, MIMichigan | — | $537.59 |
| Rest of MichiganMichigan | — | $499.88 |
| MinnesotaMinnesota | — | $486.96 |
| Metropolitan Kansas City, MOMissouri | — | $498.60 |
| Metropolitan St. Louis, MOMissouri | — | $502.69 |
| Rest of MissouriMissouri | — | $481.18 |
| MississippiMississippi | — | $469.97 |
| MontanaMontana | — | $513.28 |
| North CarolinaNorth Carolina | — | $481.45 |
| North DakotaNorth Dakota | — | $485.60 |
| NebraskaNebraska | — | $467.00 |
| New HampshireNew Hampshire | — | $516.73 |
| Northern New JerseyNew Jersey | — | $567.72 |
| Rest of New JerseyNew Jersey | — | $548.24 |
| New MexicoNew Mexico | — | $504.14 |
| NevadaNevada | — | $505.79 |
| NYC suburbs and Long Island, NYNew York | — | $611.37 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $555.41 |
| Queens, NYNew York | — | $590.39 |
| Rest of New YorkNew York | — | $488.26 |
| OhioOhio | — | $494.22 |
| OklahomaOklahoma | — | $478.93 |
| Portland, OROregon | — | $530.19 |
| Rest of OregonOregon | — | $498.59 |
| Metropolitan Philadelphia, PAPennsylvania | — | $535.96 |
| Rest of PennsylvaniaPennsylvania | — | $492.39 |
| Rhode IslandRhode Island | — | $520.33 |
| South CarolinaSouth Carolina | — | $489.30 |
| South DakotaSouth Dakota | — | $482.32 |
| TennesseeTennessee | — | $471.30 |
| Austin, TXTexas | — | $521.54 |
| Beaumont, TXTexas | — | $489.85 |
| Brazoria, TXTexas | — | $503.00 |
| Dallas, TXTexas | — | $508.01 |
| Fort Worth, TXTexas | — | $506.38 |
| Galveston, TXTexas | — | $505.69 |
| Houston, TXTexas | — | $531.32 |
| Rest of TexasTexas | — | $497.39 |
| UtahUtah | — | $495.13 |
| VirginiaVirginia | — | $495.81 |
| Virgin Islands, VIUnited States Virgin Islands | — | $515.14 |
| VermontVermont | — | $488.03 |
| Rest of WashingtonWashington | — | $517.24 |
| King County, WAWashington | — | $567.87 |
| WisconsinWisconsin | — | $471.59 |
| West VirginiaWest Virginia | — | $504.12 |
| WyomingWyoming | — | $501.21 |
19328 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 19328 rate is calculated
Each of 19328’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 · 19328
RVUs × geographic indexes × conversion factor
Work7.25
7.25 RVUs× 1.000 GPCI
Practice expense6.72
6.72 RVUs× 1.000 GPCI
Malpractice1.40
1.40 RVUs× 1.000 GPCI
Adjusted RVUs
15.3700
Conversion factor
$33.4009
Medicare rate
$513.37
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Puerto Rico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,695
- Code
- 19328
- Physician work
- 7.25
- Practice expense
- 6.72
- Malpractice
- 1.40
GPCI2026.csv
91
- Locality
- Puerto Rico
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.25 | × 1.000 | 7.2500 |
| Practice expense | 6.72 | × 1.011 | 6.7939 |
| Malpractice | 1.40 | × 0.985 | 1.3790 |
| Total RVUs | 15.4229 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Puerto Rico$515.14
Facility: (7.25 × 1 + 6.72 × 1.011 + 1.4 × 0.985) × $33.4009 = $515.14
Payment rules and modifiers for 19328
19328 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 19328
Implant removal, intact implant
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.71/0.19 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 19328
Implant removal, intact implant
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
19328 without 50 · national facility
$513.37
Implant removal, intact implant
19328-50 · Bilateral: 150%
$770.06
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).
How 19328 has changed in Puerto Rico
19328 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $515.14 | RVU26D |
| 2026-07-01 | Not available in this setting | $515.14 | RVU26C |
| 2026-04-01 | Not available in this setting | $515.14 | RVU26B |
| 2026-01-01 | Not available in this setting | $515.14 | RVU26A |
| 2025-10-01 | Not available in this setting | $547.65 | RVU25D |
| 2025-07-01 | Not available in this setting | $547.65 | RVU25C |
| 2025-04-01 | Not available in this setting | $547.65 | RVU25B |
| 2025-01-01 | Not available in this setting | $547.65 | RVU25A |
| 2024-10-01 | Not available in this setting | $557.21 | RVU24D |
| 2024-07-01 | Not available in this setting | $557.21 | RVU24C |
| 2024-04-01 | Not available in this setting | $557.21 | RVU24B |
| 2024-03-09 | Not available in this setting | $557.21 | RVU24AR |
| 2024-01-01 | Not available in this setting | $548.12 | RVU24A |
| 2023-10-01 | Not available in this setting | $564.57 | RVU23D |
| 2023-07-01 | Not available in this setting | $563.21 | RVU23C |
| 2023-04-01 | Not available in this setting | $563.21 | RVU23B |
| 2023-01-01 | Not available in this setting | $563.21 | RVU23A |
| 2022-10-01 | Not available in this setting | $568.96 | RVU22D |
| 2022-07-01 | Not available in this setting | $568.96 | RVU22C |
| 2022-04-01 | Not available in this setting | $568.96 | RVU22B |
| 2022-01-01 | Not available in this setting | $568.96 | RVU22A |
| 2021-10-01 | Not available in this setting | $569.13 | RVU21D |
| 2021-07-01 | Not available in this setting | $569.13 | RVU21C |
| 2021-04-01 | Not available in this setting | $569.13 | RVU21B |
| 2021-01-01 | Not available in this setting | $569.13 | RVU21A |
| 2020-10-01 | Not available in this setting | $522.22 | RVU20D |
| 2020-07-01 | Not available in this setting | $522.22 | RVU20C |
| 2020-04-01 | Not available in this setting | $522.22 | RVU20B |
| 2020-01-01 | Not available in this setting | $522.22 | RVU20A |
| 2019-10-01 | Not available in this setting | $515.54 | RVU19D |
| 2019-07-01 | Not available in this setting | $515.54 | RVU19C |
| 2019-04-01 | Not available in this setting | $515.54 | RVU19B |
| 2019-01-01 | Not available in this setting | $515.54 | RVU19A |
| 2018-10-01 | Not available in this setting | $513.90 | RVU18D |
| 2018-07-01 | Not available in this setting | $513.90 | RVU18C |
| 2018-04-01 | Not available in this setting | $513.90 | RVU18B |
| 2018-01-01 | Not available in this setting | $513.90 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $461.58 | RVU17D |
| 2017-07-01 | Not available in this setting | $461.58 | RVU17C |
| 2017-04-01 | Not available in this setting | $461.58 | RVU17B |
| 2017-01-01 | Not available in this setting | $461.58 | RVU17A |
| 2016-10-01 | Not available in this setting | $409.92 | RVU16D |
| 2016-07-01 | Not available in this setting | $409.92 | RVU16C |
| 2016-04-01 | Not available in this setting | $409.92 | RVU16B |
| 2016-01-01 | Not available in this setting | $409.92 | RVU16A |
| 2015-10-01 | Not available in this setting | $410.78 | RVU15D |
| 2015-07-01 | Not available in this setting | $410.78 | RVU15C |
| 2015-04-01 | Not available in this setting | $408.74 | RVU15B |
| 2015-01-01 | Not available in this setting | $408.74 | RVU15A |
| 2014-10-01 | Not available in this setting | $405.85 | RVU14D |
| 2014-07-01 | Not available in this setting | $405.85 | RVU14C |
| 2014-04-01 | Not available in this setting | $405.85 | RVU14B |
| 2014-01-01 | Not available in this setting | $405.85 | RVU14A |
| 2013-10-01 | Not available in this setting | $396.02 | RVU13D |
| 2013-07-01 | Not available in this setting | $396.02 | RVU13C |
| 2013-04-01 | Not available in this setting | $396.02 | RVU13B |
| 2013-01-01 | Not available in this setting | $396.02 | RVU13AR |
Where the Puerto Rico rate applies
Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.
- Aceitunas
- Adjuntas
- Aguada
- Aguadilla
- Aguas Buenas
- Aguas Claras
- Aguilita
- Aibonito
19328 billing questions
How does this differ from removal of a ruptured implant?
Use this code when the implant is intact at removal. The related ruptured-implant code, 19330, describes removal when the implant is ruptured.
Can this be reported with complete capsulectomy?
Code 19371 describes complete periprosthetic capsulectomy and includes implant removal. Review the operative report before separately reporting 19328 for the same removal.
What if a new implant is placed during the same operation?
Code 19342 may describe replacement implant placement when performed separately from mastectomy. Document both the removal and replacement work, and apply the same-session multiple-procedure payment rule.
How is bilateral removal reported?
For bilateral procedures reported with modifier 50, CMS pays at 150%. Document removal on both sides.
What postoperative care is 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
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