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CMS RVU26D · Effective 2026-10-01

19355 in Wyoming**

Office / nonfacility

$800.69

Base rate per service

Facility setting

$548.85

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 19355: Surgical correction of inverted nipple

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

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.

CMS billing rules for 19355

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
Assistant at surgery is paid only with documentation of medical necessity.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU8.31 · 34%
  • Practice expense (office) RVU14.53 · 60%
  • Malpractice RVU1.53 · 6%

37

Medicare services in 2024 · #5535 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.

19355 compared with similar codes

Office rates for Wyoming**, from the same CMS release.

19350

Nipple reconstruction

Nipple–areola reconstruction

$879.31

19355 corrects inversion of an existing nipple. 19350 addresses nipple or areola reconstruction, such as when the nipple is absent.

19316

Breast lift

Ptosis correction

No office rate

19316 is a breast lift for ptosis. It is not the code for an operation whose goal is correction of nipple inversion.

19318

Breast reduction

Tissue removal and reshaping

No office rate

19318 addresses breast reduction. Choose 19355 when the operative target is an inverted nipple, not breast size.

The same code, a different location

How does Wyoming** compare?

19355 across payment areas

Same release and payment basis · bars start at $0

  1. Wyoming** · This locality

    $800.69

  2. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $897.00

    $96.31 higher than Wyoming**

  3. Dc + Md/Va Suburbs

    $921.13

    $120.44 higher than Wyoming**

  4. Miami

    $912.01

    $111.32 higher than Wyoming**

  5. Chicago

    $884.53

    $83.84 higher than Wyoming**

  6. Manhattan

    $940.31

    $139.62 higher than Wyoming**

  7. Alaska*

    $961.36

    $160.67 higher than Wyoming**

Other payment areas listed in Wyoming appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 19355 ranges from $720.77 in Arkansas to $1035.31 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

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

  • Alabama

    Alabama · 19355

    Office

    $731.14

    Facility

    $510.77

    $69.55 lower than Wyoming** for the office setting.

  • Arkansas

    Arkansas · 19355

    Office

    $720.77

    Facility

    $504.43

    $79.92 lower than Wyoming** for the office setting.

  • Arizona

    Arizona · 19355

    Office

    $791.58

    Facility

    $547.54

    $9.11 lower than Wyoming** for the office setting.

  • Bakersfield

    California · 19355

    Office

    $845.86

    Facility

    $569.84

    $45.17 higher than Wyoming** for the office setting.

  • Chico

    California · 19355

    Office

    $841.58

    Facility

    $565.56

    $40.89 higher than Wyoming** for the office setting.

  • El Centro

    California · 19355

    Office

    $841.83

    Facility

    $565.81

    $41.14 higher than Wyoming** for the office setting.

  • Fresno

    California · 19355

    Office

    $841.58

    Facility

    $565.56

    $40.89 higher than Wyoming** for the office setting.

  • Hanford-Corcoran

    California · 19355

    Office

    $841.58

    Facility

    $565.56

    $40.89 higher than Wyoming** for the office setting.

  • Madera

    California · 19355

    Office

    $841.58

    Facility

    $565.56

    $40.89 higher than Wyoming** for the office setting.

  • Merced

    California · 19355

    Office

    $841.58

    Facility

    $565.56

    $40.89 higher than Wyoming** for the office setting.

  • Modesto

    California · 19355

    Office

    $841.58

    Facility

    $565.56

    $40.89 higher than Wyoming** for the office setting.

  • Napa

    California · 19355

    Office

    $960.65

    Facility

    $628.72

    $159.96 higher than Wyoming** for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 19355

    Office

    $890.81

    Facility

    $593.13

    $90.12 higher than Wyoming** for the office setting.

  • Redding

    California · 19355

    Office

    $841.58

    Facility

    $565.56

    $40.89 higher than Wyoming** for the office setting.

  • Rest Of California

    California · 19355

    Office

    $841.58

    Facility

    $565.56

    $40.89 higher than Wyoming** for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 19355

    Office

    $858.05

    Facility

    $582.03

    $57.36 higher than Wyoming** for the office setting.

  • Sacramento-Roseville-Folsom

    California · 19355

    Office

    $879.37

    Facility

    $586.47

    $78.68 higher than Wyoming** for the office setting.

  • Salinas

    California · 19355

    Office

    $876.04

    Facility

    $584.15

    $75.35 higher than Wyoming** for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 19355

    Office

    $894.02

    Facility

    $592.82

    $93.33 higher than Wyoming** for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 19355

    Office

    $1011.68

    Facility

    $656.58

    $210.99 higher than Wyoming** for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 19355

    Office

    $1009.94

    Facility

    $654.84

    $209.25 higher than Wyoming** for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 19355

    Office

    $1035.31

    Facility

    $672.15

    $234.62 higher than Wyoming** for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 19355

    Office

    $1028.21

    Facility

    $665.05

    $227.52 higher than Wyoming** for the office setting.

  • San Luis Obispo-Paso Robles

    California · 19355

    Office

    $862.45

    Facility

    $575.60

    $61.76 higher than Wyoming** for the office setting.

  • Santa Cruz-Watsonville

    California · 19355

    Office

    $900.44

    Facility

    $594.45

    $99.75 higher than Wyoming** for the office setting.

  • Santa Maria-Santa Barbara

    California · 19355

    Office

    $878.60

    Facility

    $584.95

    $77.91 higher than Wyoming** for the office setting.

  • Santa Rosa-Petaluma

    California · 19355

    Office

    $909.25

    Facility

    $599.98

    $108.56 higher than Wyoming** for the office setting.

  • Stockton

    California · 19355

    Office

    $841.58

    Facility

    $565.56

    $40.89 higher than Wyoming** for the office setting.

  • Vallejo

    California · 19355

    Office

    $958.15

    Facility

    $626.22

    $157.46 higher than Wyoming** for the office setting.

  • Visalia

    California · 19355

    Office

    $841.58

    Facility

    $565.56

    $40.89 higher than Wyoming** for the office setting.

  • Yuba City

    California · 19355

    Office

    $841.58

    Facility

    $565.56

    $40.89 higher than Wyoming** for the office setting.

  • Colorado

    Colorado · 19355

    Office

    $837.18

    Facility

    $569.22

    $36.49 higher than Wyoming** for the office setting.

  • Connecticut

    Connecticut · 19355

    Office

    $867.63

    Facility

    $596.40

    $66.94 higher than Wyoming** for the office setting.

  • Delaware

    Delaware · 19355

    Office

    $804.38

    Facility

    $555.56

    $3.69 higher than Wyoming** for the office setting.

  • Fort Lauderdale

    Florida · 19355

    Office

    $861.58

    Facility

    $606.46

    $60.89 higher than Wyoming** for the office setting.

  • Rest Of Florida

    Florida · 19355

    Office

    $818.33

    Facility

    $577.57

    $17.64 higher than Wyoming** for the office setting.

  • Atlanta

    Georgia · 19355

    Office

    $832.85

    Facility

    $576.98

    $32.16 higher than Wyoming** for the office setting.

  • Rest Of Georgia

    Georgia · 19355

    Office

    $771.38

    Facility

    $546.73

    $29.31 lower than Wyoming** for the office setting.

  • Hawaii, Guam

    Hawaii · 19355

    Office

    $858.95

    Facility

    $572.61

    $58.26 higher than Wyoming** for the office setting.

  • Iowa

    Iowa · 19355

    Office

    $741.91

    Facility

    $511.48

    $58.78 lower than Wyoming** for the office setting.

  • Idaho

    Idaho · 19355

    Office

    $748.22

    Facility

    $516.53

    $52.47 lower than Wyoming** for the office setting.

  • East St. Louis

    Illinois · 19355

    Office

    $826.97

    Facility

    $595.28

    $26.28 higher than Wyoming** for the office setting.

  • Rest Of Illinois

    Illinois · 19355

    Office

    $800.53

    Facility

    $570.60

    $0.16 lower than Wyoming** for the office setting.

  • Suburban Chicago

    Illinois · 19355

    Office

    $868.48

    Facility

    $609.84

    $67.79 higher than Wyoming** for the office setting.

  • Indiana

    Indiana · 19355

    Office

    $752.28

    Facility

    $518.83

    $48.41 lower than Wyoming** for the office setting.

  • Kansas

    Kansas · 19355

    Office

    $742.04

    Facility

    $514.38

    $58.65 lower than Wyoming** for the office setting.

  • Kentucky

    Kentucky · 19355

    Office

    $755.77

    Facility

    $531.88

    $44.92 lower than Wyoming** for the office setting.

  • New Orleans

    Louisiana · 19355

    Office

    $792.30

    Facility

    $555.31

    $8.39 lower than Wyoming** for the office setting.

  • Rest Of Louisiana

    Louisiana · 19355

    Office

    $756.02

    Facility

    $533.14

    $44.67 lower than Wyoming** for the office setting.

  • Metropolitan Boston

    Massachusetts · 19355

    Office

    $913.89

    Facility

    $613.19

    $113.20 higher than Wyoming** for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 19355

    Office

    $833.77

    Facility

    $568.58

    $33.08 higher than Wyoming** for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 19355

    Office

    $865.96

    Facility

    $595.73

    $65.27 higher than Wyoming** for the office setting.

  • Rest Of Maryland

    Maryland · 19355

    Office

    $818.39

    Facility

    $563.52

    $17.70 higher than Wyoming** for the office setting.

  • Rest Of Maine

    Maine · 19355

    Office

    $755.84

    Facility

    $524.14

    $44.85 lower than Wyoming** for the office setting.

  • Southern Maine

    Maine · 19355

    Office

    $790.75

    Facility

    $541.18

    $9.94 lower than Wyoming** for the office setting.

  • Detroit

    Michigan · 19355

    Office

    $832.05

    Facility

    $589.02

    $31.36 higher than Wyoming** for the office setting.

  • Rest Of Michigan

    Michigan · 19355

    Office

    $778.35

    Facility

    $548.42

    $22.34 lower than Wyoming** for the office setting.

  • Minnesota

    Minnesota · 19355

    Office

    $792.08

    Facility

    $532.93

    $8.61 lower than Wyoming** for the office setting.

  • Metropolitan Kansas City

    Missouri · 19355

    Office

    $783.20

    Facility

    $546.72

    $17.49 lower than Wyoming** for the office setting.

  • Metropolitan St. Louis

    Missouri · 19355

    Office

    $790.79

    Facility

    $551.03

    $9.90 lower than Wyoming** for the office setting.

  • Rest Of Missouri

    Missouri · 19355

    Office

    $745.68

    Facility

    $528.59

    $55.01 lower than Wyoming** for the office setting.

  • Mississippi

    Mississippi · 19355

    Office

    $733.18

    Facility

    $516.35

    $67.51 lower than Wyoming** for the office setting.

  • Montana**

    Montana · 19355

    Office

    $813.88

    Facility

    $562.03

    $13.19 higher than Wyoming** for the office setting.

  • North Carolina

    North Carolina · 19355

    Office

    $763.02

    Facility

    $528.05

    $37.67 lower than Wyoming** for the office setting.

  • North Dakota**

    North Dakota · 19355

    Office

    $783.62

    Facility

    $531.78

    $17.07 lower than Wyoming** for the office setting.

  • Nebraska

    Nebraska · 19355

    Office

    $744.82

    Facility

    $512.37

    $55.87 lower than Wyoming** for the office setting.

  • New Hampshire

    New Hampshire · 19355

    Office

    $827.49

    Facility

    $565.32

    $26.80 higher than Wyoming** for the office setting.

  • Northern Nj

    New Jersey · 19355

    Office

    $912.59

    Facility

    $620.45

    $111.90 higher than Wyoming** for the office setting.

  • Rest Of New Jersey

    New Jersey · 19355

    Office

    $874.69

    Facility

    $599.68

    $74.00 higher than Wyoming** for the office setting.

  • New Mexico

    New Mexico · 19355

    Office

    $783.97

    Facility

    $553.03

    $16.72 lower than Wyoming** for the office setting.

  • Nevada**

    Nevada · 19355

    Office

    $805.93

    Facility

    $553.84

    $5.24 higher than Wyoming** for the office setting.

  • Nyc Suburbs/Long Island

    New York · 19355

    Office

    $967.26

    Facility

    $667.82

    $166.57 higher than Wyoming** for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 19355

    Office

    $883.31

    Facility

    $607.54

    $82.62 higher than Wyoming** for the office setting.

  • Queens

    New York · 19355

    Office

    $942.66

    Facility

    $644.98

    $141.97 higher than Wyoming** for the office setting.

  • Rest Of New York

    New York · 19355

    Office

    $774.54

    Facility

    $535.29

    $26.15 lower than Wyoming** for the office setting.

  • Ohio

    Ohio · 19355

    Office

    $772.17

    Facility

    $542.23

    $28.52 lower than Wyoming** for the office setting.

  • Oklahoma

    Oklahoma · 19355

    Office

    $750.66

    Facility

    $525.76

    $50.03 lower than Wyoming** for the office setting.

  • Portland

    Oregon · 19355

    Office

    $859.21

    Facility

    $579.41

    $58.52 higher than Wyoming** for the office setting.

  • Rest Of Oregon

    Oregon · 19355

    Office

    $796.86

    Facility

    $546.03

    $3.83 lower than Wyoming** for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 19355

    Office

    $848.74

    Facility

    $586.57

    $48.05 higher than Wyoming** for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 19355

    Office

    $771.37

    Facility

    $540.18

    $29.32 lower than Wyoming** for the office setting.

  • Puerto Rico

    Puerto Rico · 19355

    Office

    $818.55

    Facility

    $563.94

    $17.86 higher than Wyoming** for the office setting.

  • Rhode Island

    Rhode Island · 19355

    Office

    $829.75

    Facility

    $569.60

    $29.06 higher than Wyoming** for the office setting.

  • South Carolina

    South Carolina · 19355

    Office

    $769.43

    Facility

    $536.73

    $31.26 lower than Wyoming** for the office setting.

  • South Dakota**

    South Dakota · 19355

    Office

    $780.05

    Facility

    $528.20

    $20.64 lower than Wyoming** for the office setting.

  • Tennessee

    Tennessee · 19355

    Office

    $746.16

    Facility

    $517.23

    $54.53 lower than Wyoming** for the office setting.

  • Austin

    Texas · 19355

    Office

    $836.86

    Facility

    $570.41

    $36.17 higher than Wyoming** for the office setting.

  • Beaumont

    Texas · 19355

    Office

    $766.67

    Facility

    $537.50

    $34.02 lower than Wyoming** for the office setting.

  • Brazoria

    Texas · 19355

    Office

    $800.59

    Facility

    $551.01

    $0.10 lower than Wyoming** for the office setting.

  • Dallas

    Texas · 19355

    Office

    $807.28

    Facility

    $556.44

    $6.59 higher than Wyoming** for the office setting.

  • Fort Worth

    Texas · 19355

    Office

    $803.09

    Facility

    $554.77

    $2.40 higher than Wyoming** for the office setting.

  • Galveston

    Texas · 19355

    Office

    $804.01

    Facility

    $553.93

    $3.32 higher than Wyoming** for the office setting.

  • Houston

    Texas · 19355

    Office

    $832.02

    Facility

    $581.94

    $31.33 higher than Wyoming** for the office setting.

  • Rest Of Texas

    Texas · 19355

    Office

    $784.27

    Facility

    $545.27

    $16.42 lower than Wyoming** for the office setting.

  • Utah

    Utah · 19355

    Office

    $779.65

    Facility

    $542.92

    $21.04 lower than Wyoming** for the office setting.

  • Virginia

    Virginia · 19355

    Office

    $790.71

    Facility

    $543.14

    $9.98 lower than Wyoming** for the office setting.

  • Virgin Islands

    United States Virgin Islands · 19355

    Office

    $818.55

    Facility

    $563.94

    $17.86 higher than Wyoming** for the office setting.

  • Vermont

    Vermont · 19355

    Office

    $783.88

    Facility

    $534.56

    $16.81 lower than Wyoming** for the office setting.

  • Rest Of Washington

    Washington · 19355

    Office

    $831.10

    Facility

    $565.91

    $30.41 higher than Wyoming** for the office setting.

  • Seattle (King Cnty)

    Washington · 19355

    Office

    $928.67

    Facility

    $619.66

    $127.98 higher than Wyoming** for the office setting.

  • Wisconsin

    Wisconsin · 19355

    Office

    $758.23

    Facility

    $516.97

    $42.46 lower than Wyoming** for the office setting.

  • West Virginia

    West Virginia · 19355

    Office

    $772.43

    Facility

    $553.58

    $28.26 lower than Wyoming** for the office setting.

See how rates vary across the country

19355 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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 all state and territory rates as a table
State / territoryRate 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

Explore 19355 on the national rate map →

Where does this rate apply?

Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, 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.

Browse all communities in Wyoming →

Why are the office and facility amounts different?

For 19355 in Wyoming**, the physician’s office rate is $800.69 and the facility-setting rate is $548.85: a difference of $251.84.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 19355 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$880.76

$800.69 × 110% = $880.76

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.

Compare your contract offer →

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 19355 in Wyoming**.

PPRRVU2026_Oct_nonQPP.csv

1,700

Code
19355
Physician work
8.31
Practice expense
14.53
Malpractice
1.53

GPCI2026.csv

112

Locality
Wyoming**
Physician work
1.000
Practice expense
1.000
Malpractice
0.740
Office / nonfacility calculation for 19355 in Wyoming**
ComponentRVULocality factorAdjusted
Physician work8.31× 1.0008.3100
Practice expense14.53× 1.00014.5300
Malpractice1.53× 0.7401.1322
Total RVUs23.9722
Conversion factor× 33.4009

Office / nonfacility rate, Wyoming**$800.69

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 19355 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work8.311
Practice expense14.531
Malpractice1.530.74

(8.31 × 1 + 14.53 × 1 + 1.53 × 0.74) × $33.4009 = $800.69

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work8.311
Practice expense6.991
Malpractice1.530.74

(8.31 × 1 + 6.99 × 1 + 1.53 × 0.74) × $33.4009 = $548.85

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

19355 · Office / nonfacility

$800.69

Effective 2026-10-01

The base rate is $73.77 higher than on 2025-10-01, moving from $726.92 to $800.69 (10.1%).

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

    $726.92changed to$800.69

    • 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
    • Malpractice GPCI 0.739 changed to 0.740

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $726.92

    Held through RVU25B, RVU25C, RVU25D.

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 fromOffice / nonfacilityFacilityCMS release
2026-10-01$800.69$548.85RVU26D
2026-07-01$800.69$548.85RVU26C
2026-04-01$800.69$548.85RVU26B
2026-01-01$800.69$548.85RVU26A
2025-10-01$726.92$594.30RVU25D
2025-07-01$726.92$594.30RVU25C
2025-04-01$726.92$594.30RVU25B
2025-01-01$726.92$594.30RVU25A

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 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.

RVUs for 19355PPRRVU2026_Oct_nonQPP.csv, line 1,700 (RVU26D)
Geographic factors for Wyoming**GPCI2026.csv, line 112 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet