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CPT code 19355: Nipple correction, existing inverted nipple2026 Medicare rate & RVUs in South Carolina

Corrects an inverted nipple by surgery when eversion is the operative goal, rather than reconstruction of a missing nipple or broader breast surgery.

CMS RVU26DEffective Oct 1, 2026One payment locality37 Medicare services in 2024

In South Carolina, Medicare pays $769.43 for 19355 in the office and $536.73 when it’s performed in a hospital or facility.

$769.43Office (non-facility)
$536.73Hospital or facility
−5.5%vs the national office rate ($813.98)

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.

We’ll open 19355 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Carolina
  2. What 19355 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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 South Carolina 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. South Carolina pays $769.43. The RVUs are the same everywhere; the geographic indexes change the dollars.

19355 in South Carolina vs other payment areas
  1. South Carolina · this page$769.43
  2. Los Angeles, CA · California$897.00+$127.57
  3. Washington, DC area · District of Columbia$921.13+$151.70
  4. Miami, FL · Florida$912.01+$142.58
  5. Chicago, IL · Illinois$884.53+$115.10
  6. Manhattan, NY · New York$940.31+$170.88
  7. Alaska · Alaska$961.36+$191.93

Other areas in South Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

19355 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$731.14$510.77
ArkansasArkansas$720.77$504.43
ArizonaArizona$791.58$547.54
Bakersfield, CACalifornia$845.86$569.84
Chico, CACalifornia$841.58$565.56
El Centro, CACalifornia$841.83$565.81
Fresno, CACalifornia$841.58$565.56
Hanford, CACalifornia$841.58$565.56

19355 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$720.77

$961.36

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
19355 office rate range by state
State / territoryOffice rate rangeLocalities
AK$961.361
AL$731.141
AR$720.771
AZ$791.581
CA$841.58–$1,035.3129
CO$837.181
CT$867.631
DC$921.131
DE$804.381
FL$818.33–$912.013
GA$771.38–$832.852
GU$858.951
HI$858.951
IA$741.911
ID$748.221
IL$800.53–$884.534
IN$752.281
KS$742.041
KY$755.771
LA$756.02–$792.302
MA$833.77–$913.892
MD$818.39–$921.133
ME$755.84–$790.752
MI$778.35–$832.052
MN$792.081
MO$745.68–$790.793
MS$733.181
MT$813.881
NC$763.021
ND$783.621
NE$744.821
NH$827.491
NJ$874.69–$912.592
NM$783.971
NV$805.931
NY$774.54–$967.265
OH$772.171
OK$750.661
OR$796.86–$859.212
PA$771.37–$848.742
PR$818.551
RI$829.751
SC$769.431
SD$780.051
TN$746.161
TX$766.67–$836.868
UT$779.651
VA$790.71–$921.132
VI$818.551
VT$783.881
WA$831.10–$928.672
WI$758.231
WV$772.431
WY$800.691

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.

How the rate is built · 19355

RVUs × geographic indexes × conversion factor

Office or facility?

Work8.31

8.31 RVUs× 1.000 GPCI

Practice expense14.53

14.53 RVUs× 1.000 GPCI

Malpractice1.53

1.53 RVUs× 1.000 GPCI

Adjusted RVUs

24.3700

Conversion factor

$33.4009

Medicare rate

$813.98

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

The exact South Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,700

Code
19355
Physician work
8.31
Practice expense
14.53
Malpractice
1.53

GPCI2026.csv

93

Locality
South Carolina
Physician work
1.000
Practice expense
0.924
Malpractice
0.850
Office calculation for 19355 in South Carolina
ComponentRVULocality factorAdjusted
Physician work8.31× 1.0008.3100
Practice expense14.53× 0.92413.4257
Malpractice1.53× 0.8501.3005
Total RVUs23.0362
Conversion factor× 33.4009

Office rate, South Carolina$769.43

Office: (8.31 × 1 + 14.53 × 0.924 + 1.53 × 0.85) × $33.4009 = $769.43

Facility: (8.31 × 1 + 6.99 × 0.924 + 1.53 × 0.85) × $33.4009 = $536.73

Open 19355 in the RVU calculator

Payment rules and modifiers for 19355

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

CMS payment indicators · 19355

Nipple correction, existing inverted nipple

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 · 19355

Nipple correction, existing inverted nipple

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

19355 without 50 · national office

$813.98

Nipple correction, existing inverted nipple

19355-50 · Bilateral: 150%

$1,220.97

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

Codes related to 19355

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

Codes related to 19355
CodeHow it relatesOffice range, South Carolina
Used instead
19350Nipple reconstruction, nipple–areola reconstructionRelated nipple surgery; used for nipple or areola reconstruction rather than correcting an existing inverted nipple.$844.29

How 19355 has changed in South Carolina

19355 · Office / nonfacility

$769.43

Effective 2026-10-01

The base rate is $74.60 higher than on 2025-10-01, moving from $694.83 to $769.43 (10.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $694.83changed to$769.43

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 8.52 changed to 8.31
    • Practice expense RVU 12.80 changed to 14.53
    • Malpractice RVU 1.56 changed to 1.53
    • Practice expense GPCI 0.913 changed to 0.924
    • Malpractice GPCI 0.817 changed to 0.850

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $711.37changed to$694.83

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 12.67 changed to 12.80
    • Malpractice RVU 1.57 changed to 1.56

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $699.76changed to$711.37

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $717.41changed to$699.76

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 12.65 changed to 12.67
    • Malpractice RVU 1.54 changed to 1.57
    • Practice expense GPCI 0.908 changed to 0.913
    • Malpractice GPCI 0.756 changed to 0.817

  5. January 1, 2023

    RVU23A

    $718.99changed to$717.41

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 12.38 changed to 12.65
    • Malpractice RVU 1.55 changed to 1.54
    • Practice expense GPCI 0.903 changed to 0.908
    • Malpractice GPCI 0.695 changed to 0.756

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $722.09changed to$718.99

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 12.32 changed to 12.38
    • Malpractice RVU 1.51 changed to 1.55

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $725.55changed to$722.09

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 11.74 changed to 12.32
    • Malpractice RVU 1.50 changed to 1.51
    • Practice expense GPCI 0.907 changed to 0.903
    • Malpractice GPCI 0.624 changed to 0.695

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $717.02changed to$725.55

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 11.60 changed to 11.74
    • Malpractice RVU 1.44 changed to 1.50
    • Practice expense GPCI 0.912 changed to 0.907
    • Malpractice GPCI 0.553 changed to 0.624

    Held through RVU20B, RVU20C, RVU20D.

  9. July 1, 2019

    RVU19C

    $716.42changed to$717.02

    • Malpractice RVU 1.41 changed to 1.44

    Held through RVU19D.

  10. January 1, 2019

    RVU19A

    $715.77changed to$716.42

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 11.58 changed to 11.60
    • Malpractice RVU 1.45 changed to 1.41

    Held through RVU19B.

  11. January 1, 2018

    RVU18AR1

    $659.17changed to$715.77

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 9.40 changed to 11.58
    • Malpractice RVU 2.01 changed to 1.45
    • Malpractice GPCI 0.634 changed to 0.553

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $668.84changed to$659.17

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 9.51 changed to 9.40
    • Malpractice RVU 2.08 changed to 2.01
    • Malpractice GPCI 0.715 changed to 0.634

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $669.89changed to$668.84

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 9.50 changed to 9.51
    • Malpractice RVU 2.04 changed to 2.08

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $666.56changed to$669.89

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $652.78changed to$666.56

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 9.47 changed to 9.50
    • Malpractice RVU 1.74 changed to 2.04
    • Practice expense GPCI 0.911 changed to 0.912
    • Malpractice GPCI 0.618 changed to 0.715

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $652.68changed to$652.78

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 10.69 changed to 9.47
    • Malpractice RVU 1.82 changed to 1.74
    • Practice expense GPCI 0.909 changed to 0.911
    • Malpractice GPCI 0.520 changed to 0.618

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $652.68

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$769.43$536.73RVU26D
2026-07-01$769.43$536.73RVU26C
2026-04-01$769.43$536.73RVU26B
2026-01-01$769.43$536.73RVU26A
2025-10-01$694.83$573.75RVU25D
2025-07-01$694.83$573.75RVU25C
2025-04-01$694.83$573.75RVU25B
2025-01-01$694.83$573.75RVU25A
2024-10-01$711.37$584.63RVU24D
2024-07-01$711.37$584.63RVU24C
2024-04-01$711.37$584.63RVU24B
2024-03-09$711.37$584.63RVU24AR
2024-01-01$699.76$575.09RVU24A
2023-10-01$717.41$587.87RVU23D
2023-07-01$717.41$587.87RVU23C
2023-04-01$717.41$587.87RVU23B
2023-01-01$717.41$587.87RVU23A
2022-10-01$718.99$587.43RVU22D
2022-07-01$718.99$587.43RVU22C
2022-04-01$718.99$587.43RVU22B
2022-01-01$718.99$587.43RVU22A
2021-10-01$722.09$588.81RVU21D
2021-07-01$722.09$588.81RVU21C
2021-04-01$722.09$588.81RVU21B
2021-01-01$722.09$588.81RVU21A
2020-10-01$725.55$598.87RVU20D
2020-07-01$725.55$598.87RVU20C
2020-04-01$725.55$598.87RVU20B
2020-01-01$725.55$598.87RVU20A
2019-10-01$717.02$593.11RVU19D
2019-07-01$717.02$593.11RVU19C
2019-04-01$716.42$592.51RVU19B
2019-01-01$716.42$592.51RVU19A
2018-10-01$715.77$594.30RVU18D
2018-07-01$715.77$594.30RVU18C
2018-04-01$715.77$594.30RVU18B
2018-01-01$715.77$594.30RVU18AR1
2017-10-01$659.17$543.31RVU17D
2017-07-01$659.17$543.31RVU17C
2017-04-01$659.17$543.31RVU17B
2017-01-01$659.17$543.31RVU17A
2016-10-01$668.84$549.98RVU16D
2016-07-01$668.84$549.98RVU16C
2016-04-01$668.84$549.98RVU16B
2016-01-01$668.84$549.98RVU16A
2015-10-01$669.89$550.28RVU15D
2015-07-01$669.89$550.28RVU15C
2015-04-01$666.56$547.54RVU15B
2015-01-01$666.56$547.54RVU15A
2014-10-01$652.78$535.30RVU14D
2014-07-01$652.78$535.30RVU14C
2014-04-01$652.78$535.30RVU14B
2014-01-01$652.78$535.30RVU14A
2013-10-01$652.68$525.27RVU13D
2013-07-01$652.68$525.27RVU13C
2013-04-01$652.68$525.27RVU13B
2013-01-01$652.68$525.27RVU13AR

Price 19355 for an earlier date of service

Where the South Carolina rate applies

South Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 475 cities and communities in South Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Abbeville
  • Abney Crossroads
  • Adams Run
  • Aiken
  • Alcolu
  • Allendale
  • Anderson
  • Andrews

Browse all communities in South Carolina

19355 billing questions

When should 19355 be chosen over 19350?

Use 19355 to correct an existing inverted nipple. Code 19350 concerns nipple or areola reconstruction, such as reconstruction when the nipple is absent.

How is bilateral correction reported?

For correction on both sides, report modifier 50 under the CMS bilateral rule. The CMS payment rule for this code is 150% for a bilateral procedure with modifier 50.

What documentation supports 19355?

Document the nipple inversion, side treated, the operative correction, and whether one or both nipples were treated. Include the operative goal when another breast procedure is performed in the same session.

Are related postoperative visits included?

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

Can an assistant surgeon be reported?

Assistant-at-surgery payment is allowed only when medical necessity is documented. CMS does not permit co-surgeons or team surgery for this code.

How does payment work when another procedure is performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.

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 19355PPRRVU2026_Oct_nonQPP.csv, line 1,700 (RVU26D)
Geographic factors for South CarolinaGPCI2026.csv, line 93 (RVU26D)

Open CMS sourceHow we calculate rates

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