CPT code 19371: Capsulectomy, complete peri-implant capsule2026 Medicare rate & RVUs in Washington, DC area

In Washington, DC area, Medicare pays $720.60 for 19371 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 19371 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 19371 covers

This operation removes the fibrous capsule surrounding a breast implant in its entirety and removes material contained within that capsule, including the implant. Plastic and reconstructive surgeons commonly perform it in an operating room for a contracted capsule, an implant-related complication, or a revision in which complete capsule removal is intended. The code describes capsule excision, not simple implant removal or a limited capsule release.

Report the service for each breast treated. The operative note should establish complete rather than partial capsule removal, identify the side, and describe the capsule and intracapsular contents removed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery, modifier 50 is paid at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures at 50%. CMS does not pay an assistant at surgery for this service; 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 Washington, DC area compares for 19371

Across 109 of 109 payment localities, the facility rate for 19371 runs from $582.44 in Arkansas to $801.30 in Alaska. Washington, DC area pays $720.60. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

19371 rates by state

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

See 19371 in every payment locality

How the 19371 rate is calculated

Each of 19371’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 19371

19371 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 19371

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

How 19371 has changed in Washington, DC area

Price 19371 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

• Washington

Browse all communities in District of Columbia

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