CPT code 19340: Breast implant, immediate postmastectomy placement2026 Medicare rate & RVUs in Maryland
Reports direct placement of a breast implant during the mastectomy operation for immediate reconstruction, rather than staged reconstruction with a tissue expander.
CMS doesn’t publish an office rate for 19340 in Maryland.
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
On this page 9 sections
What 19340 covers
A surgeon places a breast implant during the same operative session as a mastectomy to create an immediate breast reconstruction. This approach may follow mastectomy for breast cancer or risk reduction. Plastic surgeons commonly perform the reconstruction, sometimes with a breast surgeon performing the mastectomy, in a hospital or ambulatory surgical setting. The implant is placed directly; a tissue expander is not used as the initial reconstructive device.
Report 19340 for immediate implant placement, with the mastectomy coded separately when performed. The operative report should identify the mastectomy session, laterality, reconstructive purpose, and implant placement. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 identifies bilateral surgery, paid at 150%. Assistant-at-surgery payment is statutorily restricted; co-surgeons require supporting documentation, and team surgery is 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 19340 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | Unavailable | $743.82 |
| Rest of Maryland | Unavailable | $702.50 |
| Washington, DC area | Unavailable | $779.19 |
How the 19340 rate is calculated
Each of 19340’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 · 19340
RVUs × geographic indexes × conversion factor
Work10.22
10.22 RVUs× 1.000 GPCI
Practice expense8.76
8.76 RVUs× 1.000 GPCI
Malpractice2.01
2.01 RVUs× 1.000 GPCI
Adjusted RVUs
20.9900
Conversion factor
$33.4009
Medicare rate
$701.08
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 19340
19340 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 19340
Breast implant, immediate postmastectomy placement
| 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) | 1 | Permitted with supporting documentation. |
| 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 · 19340
Breast implant, immediate postmastectomy 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
19340 without 50 · national facility
$701.08
Breast implant, immediate postmastectomy placement
19340-50 · Bilateral: 150%
$1,051.62
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).
19340 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 19342Breast implantSeparate day from mastectomy
- Choose 19340 when the implant is placed during the mastectomy operation. Choose 19342 for implant insertion or replacement in a separate session.
- 19357Breast reconstructionTissue expander placement
- 19357 is for placement of a tissue expander as a staged reconstructive step; 19340 is for direct implant placement during mastectomy.
- 19325Breast augmentationProsthetic implant placement
- 19325 describes breast augmentation with an implant, rather than implant reconstruction performed in the mastectomy session.
19340 billing questions
How is 19340 different from 19342?
19340 describes implant placement in the same operative session as mastectomy. 19342 is used for implant insertion or replacement in a separate, later reconstruction session.
When is 19357 reported instead?
Use 19357 when the surgeon places a tissue expander as a staged step in breast reconstruction. Code 19340 describes direct implant placement during the mastectomy operation.
Is the mastectomy reported separately?
Yes. Report the applicable mastectomy procedure separately from the immediate implant reconstruction when both services are performed.
How should bilateral placement be reported?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%. The operative documentation should support implant placement on both sides.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care. Related follow-up during that period is part of the global service.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is statutorily restricted. Co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
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
Fee sheets · Coming soon
Put 19340 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist