CPT code 19371: Capsulectomy, complete peri-implant capsule2026 Medicare rate & RVUs in Texas
Reports complete removal of the capsule surrounding a breast implant, including its contents, when the surgeon performs a full capsulectomy.
CMS doesn’t publish an office rate for 19371 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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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.
Where 19371 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $658.20 |
| Beaumont, TX | Unavailable | $621.29 |
| Brazoria, TX | Unavailable | $636.03 |
| Dallas, TX | Unavailable | $642.46 |
| Fort Worth, TX | Unavailable | $640.63 |
| Galveston, TX | Unavailable | $639.50 |
| Houston, TX | Unavailable | $673.18 |
| Rest of Texas | Unavailable | $629.95 |
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.
How the rate is built · 19371
RVUs × geographic indexes × conversion factor
Work9.73
9.73 RVUs× 1.000 GPCI
Practice expense7.87
7.87 RVUs× 1.000 GPCI
Malpractice1.84
1.84 RVUs× 1.000 GPCI
Adjusted RVUs
19.4400
Conversion factor
$33.4009
Medicare rate
$649.31
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 19371
19371 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 19371
Capsulectomy, complete peri-implant capsule
| 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 · 19371
Capsulectomy, complete peri-implant capsule
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
19371 without 50 · national facility
$649.31
Capsulectomy, complete peri-implant capsule
19371-50 · Bilateral: 150%
$973.96
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).
19371 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 19370Capsule revisionPeri-implant capsule
- Use 19371 for complete capsule removal with intracapsular contents. Use 19370 when the capsule is revised but not completely excised.
- 19328Implant removalIntact implant
- 19328 describes removal of an intact implant. 19371 includes implant removal when the surgeon also performs complete capsulectomy.
- 19330Implant removalRuptured implant
- 19330 describes removal of a ruptured implant. 19371 is distinguished by complete excision of the surrounding capsule as well as removal of its contents.
- 19342Breast implantSeparate day from mastectomy
- 19342 describes insertion or replacement of an implant; 19371 describes complete removal of the peri-implant capsule and existing intracapsular contents.
19371 billing questions
How does 19371 differ from 19370?
19371 is for complete removal of the peri-implant capsule and its contents. 19370 describes revision of the capsule when the work is not a complete capsulectomy.
Does 19371 include removal of the implant?
Yes. Removal of the implant within the capsule is included, so do not separately report 19328 or 19330 for that same removal.
Can 19371 be reported when a new implant is placed?
19371 covers the complete capsule removal and removal of the existing implant. When a replacement implant is placed, 19342 may describe that placement when its requirements are met.
How is bilateral capsulectomy reported?
Report modifier 50 when the complete procedure is performed on both breasts. CMS pays bilateral 19371 at 150%.
What should the operative note document?
Document the side treated, the extent of capsule excision, and removal of the implant or other intracapsular contents. The record should distinguish complete excision from a limited capsule revision.
Is an assistant surgeon payable for 19371?
CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are 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
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