CPT code 19355: Nipple correction, existing inverted nipple2026 Medicare rate & RVUs in Riverside, CA

In Riverside, CA, Medicare pays $858.05 for 19355 in the office and $582.03 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 19355 nationwide

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

What 19355 covers

This operation corrects an existing nipple that turns inward. A breast or plastic surgeon typically performs it in an operating-room setting, often for persistent inversion associated with symptoms or functional concerns. The operative goal is to evert the nipple, not to create a nipple after mastectomy or to reshape the breast. The technique varies, so the operative report should establish the condition treated and the correction performed.

Report 19355 for the nipple-correction service, identifying the treated side and using modifier 50 when performed bilaterally under the CMS bilateral rule. The record should document the inversion, laterality, operative work, and any separate breast procedure performed in the same session. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others at 50%. 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.

How Riverside, CA compares for 19355

Across 109 of 109 payment localities, the office rate for 19355 runs from $720.77 in Arkansas to $1,035.31 in San Benito County, CA. Riverside, CA pays $858.05. The RVUs are the same everywhere; the geographic indexes change the dollars.

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19355 rates by state

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

See 19355 in every payment locality

How the 19355 rate is calculated

Each of 19355’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.

Payment rules and modifiers for 19355

19355 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

Codes related to 19355

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

How 19355 has changed in Riverside, CA

Price 19355 for an earlier date of service

Where the Riverside, CA rate applies

Riverside, CA is a Medicare payment area, not a city. Our Census mapping connects it to 127 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

• Ontario
• Riverside
• San Bernardino
• Adelanto
• Aguanga
• Anza
• Apple Valley
• Baker

Browse all communities in California

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

Open CMS sourceHow we calculate rates