No office rate
19370 represents capsule release or partial removal; 19371 is for complete capsule removal.
On this page
CMS RVU26D · Effective 2026-10-01
19370 in Austin
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$625.26
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Breast surgery
About 19370: Breast implant capsule revision
Reports surgical release or partial removal of the fibrous capsule around a breast implant, commonly performed to address capsular contracture or implant distortion.
A surgeon revises the scar-like tissue surrounding a breast implant by releasing it or removing part of it. This work is commonly performed for capsular contracture that makes the breast firm, painful, or distorted. Plastic surgeons and breast surgeons typically perform the procedure in an operating room, often during surgery that also addresses the implant itself. The capsule work is distinct from implant removal or replacement alone.
Select this code when the operative record supports revision of the capsule, such as release of a tight capsule or partial excision; complete capsule removal points to 19371. Document the affected side, the capsule work performed, the clinical problem, and any separate implant procedure. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 19370
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.94 · 48%
- Practice expense (office) RVU7.82 · 42%
- Malpractice RVU1.68 · 9%
2.7K
Medicare services in 2024 · #2242 by national volume
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.
19370 compared with similar codes
Office rates for Austin, from the same CMS release.
No office rate
19342 describes delayed placement or replacement of an implant. Use 19370 for capsule revision, not implant exchange by itself.
No office rate
19328 describes removal of an intact implant. It does not represent capsule release or partial capsule removal.
The same code, a different location
How does Austin compare?
19370 across payment areas
Same release and payment basis · bars start at $0
Austin · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Rest Of Texas
Texas · 19370
Office
Unavailable
Facility
$597.15
No comparable office rate is available.
Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)
California · 19370
Office
Unavailable
Facility
$657.10
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 19370
Office
Unavailable
Facility
$684.87
No comparable office rate is available.
Miami
Florida · 19370
Office
Unavailable
Facility
$712.42
No comparable office rate is available.
Chicago
Illinois · 19370
Office
Unavailable
Facility
$691.98
No comparable office rate is available.
Manhattan
New York · 19370
Office
Unavailable
Facility
$710.22
No comparable office rate is available.
Alaska*
Alaska · 19370
Office
Unavailable
Facility
$757.00
No comparable office rate is available.
Alabama
Alabama · 19370
Office
Unavailable
Facility
$558.91
No comparable office rate is available.
Arkansas
Arkansas · 19370
Office
Unavailable
Facility
$551.87
No comparable office rate is available.
Arizona
Arizona · 19370
Office
Unavailable
Facility
$599.74
No comparable office rate is available.
Bakersfield
California · 19370
Office
Unavailable
Facility
$624.72
No comparable office rate is available.
Chico
California · 19370
Office
Unavailable
Facility
$620.03
No comparable office rate is available.
El Centro
California · 19370
Office
Unavailable
Facility
$620.31
No comparable office rate is available.
Fresno
California · 19370
Office
Unavailable
Facility
$620.03
No comparable office rate is available.
Hanford-Corcoran
California · 19370
Office
Unavailable
Facility
$620.03
No comparable office rate is available.
Madera
California · 19370
Office
Unavailable
Facility
$620.03
No comparable office rate is available.
Merced
California · 19370
Office
Unavailable
Facility
$620.03
No comparable office rate is available.
Modesto
California · 19370
Office
Unavailable
Facility
$620.03
No comparable office rate is available.
Napa
California · 19370
Office
Unavailable
Facility
$690.18
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 19370
Office
Unavailable
Facility
$650.66
No comparable office rate is available.
Redding
California · 19370
Office
Unavailable
Facility
$620.03
No comparable office rate is available.
Rest Of California
California · 19370
Office
Unavailable
Facility
$620.03
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 19370
Office
Unavailable
Facility
$638.11
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 19370
Office
Unavailable
Facility
$643.20
No comparable office rate is available.
Salinas
California · 19370
Office
Unavailable
Facility
$640.66
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 19370
Office
Unavailable
Facility
$650.36
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 19370
Office
Unavailable
Facility
$721.01
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 19370
Office
Unavailable
Facility
$719.10
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 19370
Office
Unavailable
Facility
$738.17
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 19370
Office
Unavailable
Facility
$730.37
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 19370
Office
Unavailable
Facility
$631.26
No comparable office rate is available.
Santa Cruz-Watsonville
California · 19370
Office
Unavailable
Facility
$652.30
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 19370
Office
Unavailable
Facility
$641.60
No comparable office rate is available.
Santa Rosa-Petaluma
California · 19370
Office
Unavailable
Facility
$658.39
No comparable office rate is available.
Stockton
California · 19370
Office
Unavailable
Facility
$620.03
No comparable office rate is available.
Vallejo
California · 19370
Office
Unavailable
Facility
$687.43
No comparable office rate is available.
Visalia
California · 19370
Office
Unavailable
Facility
$620.03
No comparable office rate is available.
Yuba City
California · 19370
Office
Unavailable
Facility
$620.03
No comparable office rate is available.
Colorado
Colorado · 19370
Office
Unavailable
Facility
$623.92
No comparable office rate is available.
Connecticut
Connecticut · 19370
Office
Unavailable
Facility
$653.78
No comparable office rate is available.
Delaware
Delaware · 19370
Office
Unavailable
Facility
$608.60
No comparable office rate is available.
Fort Lauderdale
Florida · 19370
Office
Unavailable
Facility
$664.65
No comparable office rate is available.
Rest Of Florida
Florida · 19370
Office
Unavailable
Facility
$632.65
No comparable office rate is available.
Atlanta
Georgia · 19370
Office
Unavailable
Facility
$632.27
No comparable office rate is available.
Rest Of Georgia
Georgia · 19370
Office
Unavailable
Facility
$598.48
No comparable office rate is available.
Hawaii, Guam
Hawaii · 19370
Office
Unavailable
Facility
$628.07
No comparable office rate is available.
Iowa
Iowa · 19370
Office
Unavailable
Facility
$559.87
No comparable office rate is available.
Idaho
Idaho · 19370
Office
Unavailable
Facility
$565.45
No comparable office rate is available.
East St. Louis
Illinois · 19370
Office
Unavailable
Facility
$651.92
No comparable office rate is available.
Rest Of Illinois
Illinois · 19370
Office
Unavailable
Facility
$624.78
No comparable office rate is available.
Suburban Chicago
Illinois · 19370
Office
Unavailable
Facility
$668.37
No comparable office rate is available.
Indiana
Indiana · 19370
Office
Unavailable
Facility
$568.00
No comparable office rate is available.
Kansas
Kansas · 19370
Office
Unavailable
Facility
$563.01
No comparable office rate is available.
Kentucky
Kentucky · 19370
Office
Unavailable
Facility
$582.15
No comparable office rate is available.
New Orleans
Louisiana · 19370
Office
Unavailable
Facility
$608.13
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 19370
Office
Unavailable
Facility
$583.52
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 19370
Office
Unavailable
Facility
$672.65
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 19370
Office
Unavailable
Facility
$623.14
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 19370
Office
Unavailable
Facility
$653.06
No comparable office rate is available.
Rest Of Maryland
Maryland · 19370
Office
Unavailable
Facility
$617.43
No comparable office rate is available.
Rest Of Maine
Maine · 19370
Office
Unavailable
Facility
$573.81
No comparable office rate is available.
Southern Maine
Maine · 19370
Office
Unavailable
Facility
$592.86
No comparable office rate is available.
Detroit
Michigan · 19370
Office
Unavailable
Facility
$645.26
No comparable office rate is available.
Rest Of Michigan
Michigan · 19370
Office
Unavailable
Facility
$600.43
No comparable office rate is available.
Minnesota
Minnesota · 19370
Office
Unavailable
Facility
$583.98
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 19370
Office
Unavailable
Facility
$598.69
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 19370
Office
Unavailable
Facility
$603.49
No comparable office rate is available.
Rest Of Missouri
Missouri · 19370
Office
Unavailable
Facility
$578.41
No comparable office rate is available.
Mississippi
Mississippi · 19370
Office
Unavailable
Facility
$564.96
No comparable office rate is available.
Montana**
Montana · 19370
Office
Unavailable
Facility
$615.80
No comparable office rate is available.
North Carolina
North Carolina · 19370
Office
Unavailable
Facility
$578.16
No comparable office rate is available.
North Dakota**
North Dakota · 19370
Office
Unavailable
Facility
$582.58
No comparable office rate is available.
Nebraska
Nebraska · 19370
Office
Unavailable
Facility
$560.90
No comparable office rate is available.
New Hampshire
New Hampshire · 19370
Office
Unavailable
Facility
$619.61
No comparable office rate is available.
Northern Nj
New Jersey · 19370
Office
Unavailable
Facility
$680.33
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 19370
Office
Unavailable
Facility
$657.33
No comparable office rate is available.
New Mexico
New Mexico · 19370
Office
Unavailable
Facility
$605.51
No comparable office rate is available.
Nevada**
Nevada · 19370
Office
Unavailable
Facility
$606.80
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 19370
Office
Unavailable
Facility
$732.48
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 19370
Office
Unavailable
Facility
$665.95
No comparable office rate is available.
Queens
New York · 19370
Office
Unavailable
Facility
$707.36
No comparable office rate is available.
Rest Of New York
New York · 19370
Office
Unavailable
Facility
$586.19
No comparable office rate is available.
Ohio
Ohio · 19370
Office
Unavailable
Facility
$593.64
No comparable office rate is available.
Oklahoma
Oklahoma · 19370
Office
Unavailable
Facility
$575.45
No comparable office rate is available.
Portland
Oregon · 19370
Office
Unavailable
Facility
$635.32
No comparable office rate is available.
Rest Of Oregon
Oregon · 19370
Office
Unavailable
Facility
$598.20
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 19370
Office
Unavailable
Facility
$642.83
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 19370
Office
Unavailable
Facility
$591.41
No comparable office rate is available.
Puerto Rico
Puerto Rico · 19370
Office
Unavailable
Facility
$617.94
No comparable office rate is available.
Rhode Island
Rhode Island · 19370
Office
Unavailable
Facility
$624.15
No comparable office rate is available.
South Carolina
South Carolina · 19370
Office
Unavailable
Facility
$587.64
No comparable office rate is available.
South Dakota**
South Dakota · 19370
Office
Unavailable
Facility
$578.65
No comparable office rate is available.
Tennessee
Tennessee · 19370
Office
Unavailable
Facility
$566.16
No comparable office rate is available.
Utah
Utah · 19370
Office
Unavailable
Facility
$594.52
No comparable office rate is available.
Virginia
Virginia · 19370
Office
Unavailable
Facility
$594.97
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 19370
Office
Unavailable
Facility
$617.94
No comparable office rate is available.
Vermont
Vermont · 19370
Office
Unavailable
Facility
$585.58
No comparable office rate is available.
Rest Of Washington
Washington · 19370
Office
Unavailable
Facility
$620.23
No comparable office rate is available.
Seattle (King Cnty)
Washington · 19370
Office
Unavailable
Facility
$679.87
No comparable office rate is available.
Wisconsin
Wisconsin · 19370
Office
Unavailable
Facility
$566.11
No comparable office rate is available.
West Virginia
West Virginia · 19370
Office
Unavailable
Facility
$605.88
No comparable office rate is available.
Wyoming**
Wyoming · 19370
Office
Unavailable
Facility
$601.32
No comparable office rate is available.
See how rates vary across the country
19370 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
- 19370 in Austin
Multiple payment areas
- 19370 in Barton Creek
- 19370 in Bee Cave
- 19370 in Briarcliff
- 19370 in Cedar Park
Multiple payment areas
- 19370 in Creedmoor
Multiple payment areas
- 19370 in Elgin
Multiple payment areas
- 19370 in Garfield
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 19370 in Austin. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$687.79
$625.26 × 110% = $687.79
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 19370 in Austin.
PPRRVU2026_Oct_nonQPP.csv
1,707
- Code
- 19370
- Physician work
- 8.94
- Practice expense
- 7.82
- Malpractice
- 1.68
GPCI2026.csv
96
- Locality
- Austin
- Physician work
- 1.002
- Practice expense
- 1.058
- Malpractice
- 0.886
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.94 | × 1.002 | 8.9579 |
| Practice expense | 7.82 | × 1.058 | 8.2736 |
| Malpractice | 1.68 | × 0.886 | 1.4885 |
| Total RVUs | 18.7199 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Austin$625.26
Open 19370 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.94 | 1.002 |
| Practice expense | 7.82 | 1.058 |
| Malpractice | 1.68 | 0.886 |
(8.94 × 1.002 + 7.82 × 1.058 + 1.68 × 0.886) × $33.4009 = $625.26
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
19370 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $625.26 | RVU26D |
| 2026-07-01 | Not available in this setting | $625.26 | RVU26C |
| 2026-04-01 | Not available in this setting | $625.26 | RVU26B |
| 2026-01-01 | Not available in this setting | $625.26 | RVU26A |
| 2025-10-01 | Not available in this setting | $671.01 | RVU25D |
| 2025-07-01 | Not available in this setting | $671.01 | RVU25C |
| 2025-04-01 | Not available in this setting | $671.01 | RVU25B |
| 2025-01-01 | Not available in this setting | $671.01 | RVU25A |
19370 billing questions
When should 19371 be used instead?
Use 19370 for capsule release or partial capsule removal. When the surgeon removes the capsule completely, report 19371.
Can implant replacement be reported with capsule revision?
When the surgeon also replaces the implant, 19342 may describe that separate work. The operative note should clearly document both the implant procedure and the capsule revision.
Does implant removal alone support 19370?
No. Removal of an intact implant is described by 19328, and removal of a ruptured implant by 19330; 19370 represents capsule revision, not removal alone.
How is bilateral capsule revision reported?
For bilateral surgery, use modifier 50; CMS pays this code at 150% under the stated bilateral rule.
Can an assistant surgeon be paid for 19370?
CMS applies a statutory restriction on assistant-at-surgery payment for this code. Co-surgeons and team surgery are also not permitted.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,70419367,,Brst rcnstj 1 pdcl tram flap,A,,26.13,15.70,NA,15.70,,4.85,46.68,46.68,0,090,0.10,0.71,0.19,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,70519368,,Brst rcnstj 1pdcl tram anast,A,,33.05,17.28,NA,17.28,,6.15,56.48,56.48,0,090,0.10,0.71,0.19,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,70619369,,Brst rcnstj 2 pdcl tram flap,A,,30.53,16.36,NA,16.36,,5.68,52.57,52.57,0,090,0.10,0.71,0.19,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,70719370,,Revj peri-implt capsule brst,A,,8.94,7.82,NA,7.82,,1.68,18.44,18.44,0,090,0.10,0.71,0.19,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,70819371,,Peri-implt capslc brst compl,A,,9.73,7.87,NA,7.87,,1.84,19.44,19.44,0,090,0.10,0.71,0.19,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,70919380,,Revj reconstructed breast,A,,10.89,9.09,NA,9.09,,2.05,22.03,22.03,0,090,0.10,0.71,0.19,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,71019396,,Design custom breast implant,A,,2.12,6.22,,1.27,,0.39,8.73,3.78,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780
9904412,TX,11,DALLAS,1.009,0.996,0.858