FeeBase
Log inGet started
Menu
On this page

CMS RVU26D · Effective 2026-10-01

19396 in Wyoming**

Office / nonfacility

$288.20

Base rate per service

Facility setting

$122.87

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 19396: Custom breast implant design and manufacture

Report custom breast implant design and manufacture for a patient-specific implant; use a separate applicable code when the implant is surgically placed.

This service covers designing and manufacturing a breast implant tailored to a patient’s anatomy rather than selecting a standard implant. Plastic surgeons involved in breast reconstruction or augmentation may coordinate the custom design with the manufacturer, using patient-specific measurements or imaging to address an unusual contour or fit. The work concerns the custom implant itself, not its surgical placement.

Report 19396 when the record supports actual custom design and manufacture; document the patient-specific features and the work performed. Report the applicable implant-placement service separately when placement is performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral reporting with modifier 50, CMS pays at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

CMS billing rules for 19396

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 RVU2.12 · 24%
  • Practice expense (office) RVU6.22 · 71%
  • Malpractice RVU0.39 · 4%

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.

19396 compared with similar codes

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

19325

Breast augmentation

Prosthetic implant placement

No office rate

Use 19396 for custom design and manufacture of a patient-specific implant. Use 19325 for breast augmentation with an implant.

19340

Breast implant

Immediate postmastectomy placement

No office rate

19340 describes implant placement in the setting of immediate reconstruction. It does not represent custom design and manufacture.

19342

Breast implant

Separate day from mastectomy

No office rate

19342 describes delayed implant placement or replacement in reconstruction. It is distinct from designing and manufacturing a custom implant.

The same code, a different location

How does Wyoming** compare?

19396 across payment areas

Same release and payment basis · bars start at $0

  1. Wyoming** · This locality

    $288.20

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

    $328.14

    $39.94 higher than Wyoming**

  3. Dc + Md/Va Suburbs

    $333.87

    $45.67 higher than Wyoming**

  4. Miami

    $320.03

    $31.83 higher than Wyoming**

  5. Chicago

    $309.99

    $21.79 higher than Wyoming**

  6. Manhattan

    $337.41

    $49.21 higher than Wyoming**

  7. Alaska*

    $334.65

    $46.45 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, 19396 ranges from $255.98 in Arkansas to $385.16 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 · 19396

    Office

    $259.97

    Facility

    $115.30

    $28.23 lower than Wyoming** for the office setting.

  • Arkansas

    Arkansas · 19396

    Office

    $255.98

    Facility

    $113.96

    $32.22 lower than Wyoming** for the office setting.

  • Arizona

    Arizona · 19396

    Office

    $283.27

    Facility

    $123.06

    $4.93 lower than Wyoming** for the office setting.

  • Bakersfield

    California · 19396

    Office

    $307.79

    Facility

    $126.58

    $19.59 higher than Wyoming** for the office setting.

  • Chico

    California · 19396

    Office

    $306.69

    Facility

    $125.49

    $18.49 higher than Wyoming** for the office setting.

  • El Centro

    California · 19396

    Office

    $306.76

    Facility

    $125.55

    $18.56 higher than Wyoming** for the office setting.

  • Fresno

    California · 19396

    Office

    $306.69

    Facility

    $125.49

    $18.49 higher than Wyoming** for the office setting.

  • Hanford-Corcoran

    California · 19396

    Office

    $306.69

    Facility

    $125.49

    $18.49 higher than Wyoming** for the office setting.

  • Madera

    California · 19396

    Office

    $306.69

    Facility

    $125.49

    $18.49 higher than Wyoming** for the office setting.

  • Merced

    California · 19396

    Office

    $306.69

    Facility

    $125.49

    $18.49 higher than Wyoming** for the office setting.

  • Modesto

    California · 19396

    Office

    $306.69

    Facility

    $125.49

    $18.49 higher than Wyoming** for the office setting.

  • Napa

    California · 19396

    Office

    $355.71

    Facility

    $137.80

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

  • Oxnard-Thousand Oaks-Ventura

    California · 19396

    Office

    $326.47

    Facility

    $131.05

    $38.27 higher than Wyoming** for the office setting.

  • Redding

    California · 19396

    Office

    $306.69

    Facility

    $125.49

    $18.49 higher than Wyoming** for the office setting.

  • Rest Of California

    California · 19396

    Office

    $306.69

    Facility

    $125.49

    $18.49 higher than Wyoming** for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 19396

    Office

    $310.89

    Facility

    $129.69

    $22.69 higher than Wyoming** for the office setting.

  • Sacramento-Roseville-Folsom

    California · 19396

    Office

    $321.96

    Facility

    $129.67

    $33.76 higher than Wyoming** for the office setting.

  • Salinas

    California · 19396

    Office

    $320.77

    Facility

    $129.15

    $32.57 higher than Wyoming** for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 19396

    Office

    $328.47

    Facility

    $130.73

    $40.27 higher than Wyoming** for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 19396

    Office

    $376.45

    Facility

    $143.33

    $88.25 higher than Wyoming** for the office setting.

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

    California · 19396

    Office

    $376.01

    Facility

    $142.88

    $87.81 higher than Wyoming** for the office setting.

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

    California · 19396

    Office

    $385.16

    Facility

    $146.75

    $96.96 higher than Wyoming** for the office setting.

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

    California · 19396

    Office

    $383.35

    Facility

    $144.94

    $95.15 higher than Wyoming** for the office setting.

  • San Luis Obispo-Paso Robles

    California · 19396

    Office

    $315.63

    Facility

    $127.31

    $27.43 higher than Wyoming** for the office setting.

  • Santa Cruz-Watsonville

    California · 19396

    Office

    $331.70

    Facility

    $130.82

    $43.50 higher than Wyoming** for the office setting.

  • Santa Maria-Santa Barbara

    California · 19396

    Office

    $322.02

    Facility

    $129.24

    $33.82 higher than Wyoming** for the office setting.

  • Santa Rosa-Petaluma

    California · 19396

    Office

    $335.04

    Facility

    $132.01

    $46.84 higher than Wyoming** for the office setting.

  • Stockton

    California · 19396

    Office

    $306.69

    Facility

    $125.49

    $18.49 higher than Wyoming** for the office setting.

  • Vallejo

    California · 19396

    Office

    $355.07

    Facility

    $137.16

    $66.87 higher than Wyoming** for the office setting.

  • Visalia

    California · 19396

    Office

    $306.69

    Facility

    $125.49

    $18.49 higher than Wyoming** for the office setting.

  • Yuba City

    California · 19396

    Office

    $306.69

    Facility

    $125.49

    $18.49 higher than Wyoming** for the office setting.

  • Colorado

    Colorado · 19396

    Office

    $302.88

    Facility

    $126.97

    $14.68 higher than Wyoming** for the office setting.

  • Connecticut

    Connecticut · 19396

    Office

    $311.74

    Facility

    $133.67

    $23.54 higher than Wyoming** for the office setting.

  • Delaware

    Delaware · 19396

    Office

    $288.14

    Facility

    $124.78

    $0.06 lower than Wyoming** for the office setting.

  • Fort Lauderdale

    Florida · 19396

    Office

    $304.82

    Facility

    $137.33

    $16.62 higher than Wyoming** for the office setting.

  • Rest Of Florida

    Florida · 19396

    Office

    $289.00

    Facility

    $130.94

    $0.80 higher than Wyoming** for the office setting.

  • Atlanta

    Georgia · 19396

    Office

    $297.74

    Facility

    $129.76

    $9.54 higher than Wyoming** for the office setting.

  • Rest Of Georgia

    Georgia · 19396

    Office

    $271.65

    Facility

    $124.18

    $16.55 lower than Wyoming** for the office setting.

  • Hawaii, Guam

    Hawaii · 19396

    Office

    $314.57

    Facility

    $126.58

    $26.37 higher than Wyoming** for the office setting.

  • Iowa

    Iowa · 19396

    Office

    $266.08

    Facility

    $114.79

    $22.12 lower than Wyoming** for the office setting.

  • Idaho

    Idaho · 19396

    Office

    $268.10

    Facility

    $116.00

    $20.10 lower than Wyoming** for the office setting.

  • East St. Louis

    Illinois · 19396

    Office

    $288.18

    Facility

    $136.07

    $0.02 lower than Wyoming** for the office setting.

  • Rest Of Illinois

    Illinois · 19396

    Office

    $280.85

    Facility

    $129.90

    $7.35 lower than Wyoming** for the office setting.

  • Suburban Chicago

    Illinois · 19396

    Office

    $307.75

    Facility

    $137.95

    $19.55 higher than Wyoming** for the office setting.

  • Indiana

    Indiana · 19396

    Office

    $269.73

    Facility

    $116.46

    $18.47 lower than Wyoming** for the office setting.

  • Kansas

    Kansas · 19396

    Office

    $265.18

    Facility

    $115.72

    $23.02 lower than Wyoming** for the office setting.

  • Kentucky

    Kentucky · 19396

    Office

    $267.42

    Facility

    $120.44

    $20.78 lower than Wyoming** for the office setting.

  • New Orleans

    Louisiana · 19396

    Office

    $281.10

    Facility

    $125.52

    $7.10 lower than Wyoming** for the office setting.

  • Rest Of Louisiana

    Louisiana · 19396

    Office

    $267.15

    Facility

    $120.83

    $21.05 lower than Wyoming** for the office setting.

  • Metropolitan Boston

    Massachusetts · 19396

    Office

    $333.36

    Facility

    $135.96

    $45.16 higher than Wyoming** for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 19396

    Office

    $301.09

    Facility

    $126.99

    $12.89 higher than Wyoming** for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 19396

    Office

    $310.98

    Facility

    $133.57

    $22.78 higher than Wyoming** for the office setting.

  • Rest Of Maryland

    Maryland · 19396

    Office

    $293.72

    Facility

    $126.40

    $5.52 higher than Wyoming** for the office setting.

  • Rest Of Maine

    Maine · 19396

    Office

    $270.05

    Facility

    $117.94

    $18.15 lower than Wyoming** for the office setting.

  • Southern Maine

    Maine · 19396

    Office

    $284.91

    Facility

    $121.07

    $3.29 lower than Wyoming** for the office setting.

  • Detroit

    Michigan · 19396

    Office

    $293.25

    Facility

    $133.71

    $5.05 higher than Wyoming** for the office setting.

  • Rest Of Michigan

    Michigan · 19396

    Office

    $275.20

    Facility

    $124.25

    $13.00 lower than Wyoming** for the office setting.

  • Minnesota

    Minnesota · 19396

    Office

    $288.44

    Facility

    $118.32

    $0.24 higher than Wyoming** for the office setting.

  • Metropolitan Kansas City

    Missouri · 19396

    Office

    $278.62

    Facility

    $123.37

    $9.58 lower than Wyoming** for the office setting.

  • Metropolitan St. Louis

    Missouri · 19396

    Office

    $281.64

    Facility

    $124.25

    $6.56 lower than Wyoming** for the office setting.

  • Rest Of Missouri

    Missouri · 19396

    Office

    $262.58

    Facility

    $120.06

    $25.62 lower than Wyoming** for the office setting.

  • Mississippi

    Mississippi · 19396

    Office

    $259.31

    Facility

    $116.96

    $28.89 lower than Wyoming** for the office setting.

  • Montana**

    Montana · 19396

    Office

    $291.56

    Facility

    $126.23

    $3.36 higher than Wyoming** for the office setting.

  • North Carolina

    North Carolina · 19396

    Office

    $272.97

    Facility

    $118.71

    $15.23 lower than Wyoming** for the office setting.

  • North Dakota**

    North Dakota · 19396

    Office

    $283.85

    Facility

    $118.52

    $4.35 lower than Wyoming** for the office setting.

  • Nebraska

    Nebraska · 19396

    Office

    $267.49

    Facility

    $114.89

    $20.71 lower than Wyoming** for the office setting.

  • New Hampshire

    New Hampshire · 19396

    Office

    $298.48

    Facility

    $126.37

    $10.28 higher than Wyoming** for the office setting.

  • Northern Nj

    New Jersey · 19396

    Office

    $330.18

    Facility

    $138.39

    $41.98 higher than Wyoming** for the office setting.

  • Rest Of New Jersey

    New Jersey · 19396

    Office

    $314.80

    Facility

    $134.25

    $26.60 higher than Wyoming** for the office setting.

  • New Mexico

    New Mexico · 19396

    Office

    $276.96

    Facility

    $125.35

    $11.24 lower than Wyoming** for the office setting.

  • Nevada**

    Nevada · 19396

    Office

    $289.62

    Facility

    $124.12

    $1.42 higher than Wyoming** for the office setting.

  • Nyc Suburbs/Long Island

    New York · 19396

    Office

    $346.55

    Facility

    $149.97

    $58.35 higher than Wyoming** for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 19396

    Office

    $317.25

    Facility

    $136.21

    $29.05 higher than Wyoming** for the office setting.

  • Queens

    New York · 19396

    Office

    $339.69

    Facility

    $144.27

    $51.49 higher than Wyoming** for the office setting.

  • Rest Of New York

    New York · 19396

    Office

    $277.33

    Facility

    $120.27

    $10.87 lower than Wyoming** for the office setting.

  • Ohio

    Ohio · 19396

    Office

    $273.62

    Facility

    $122.67

    $14.58 lower than Wyoming** for the office setting.

  • Oklahoma

    Oklahoma · 19396

    Office

    $266.46

    Facility

    $118.81

    $21.74 lower than Wyoming** for the office setting.

  • Portland

    Oregon · 19396

    Office

    $312.45

    Facility

    $128.76

    $24.25 higher than Wyoming** for the office setting.

  • Rest Of Oregon

    Oregon · 19396

    Office

    $286.89

    Facility

    $122.22

    $1.31 lower than Wyoming** for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 19396

    Office

    $303.90

    Facility

    $131.78

    $15.70 higher than Wyoming** for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 19396

    Office

    $273.84

    Facility

    $122.06

    $14.36 lower than Wyoming** for the office setting.

  • Puerto Rico

    Puerto Rico · 19396

    Office

    $293.68

    Facility

    $126.53

    $5.48 higher than Wyoming** for the office setting.

  • Rhode Island

    Rhode Island · 19396

    Office

    $298.38

    Facility

    $127.59

    $10.18 higher than Wyoming** for the office setting.

  • South Carolina

    South Carolina · 19396

    Office

    $273.85

    Facility

    $121.08

    $14.35 lower than Wyoming** for the office setting.

  • South Dakota**

    South Dakota · 19396

    Office

    $282.94

    Facility

    $117.61

    $5.26 lower than Wyoming** for the office setting.

  • Tennessee

    Tennessee · 19396

    Office

    $266.65

    Facility

    $116.36

    $21.55 lower than Wyoming** for the office setting.

  • Austin

    Texas · 19396

    Office

    $302.30

    Facility

    $127.37

    $14.10 higher than Wyoming** for the office setting.

  • Beaumont

    Texas · 19396

    Office

    $271.97

    Facility

    $121.51

    $16.23 lower than Wyoming** for the office setting.

  • Brazoria

    Texas · 19396

    Office

    $287.42

    Facility

    $123.57

    $0.78 lower than Wyoming** for the office setting.

  • Dallas

    Texas · 19396

    Office

    $289.55

    Facility

    $124.87

    $1.35 higher than Wyoming** for the office setting.

  • Fort Worth

    Texas · 19396

    Office

    $287.64

    Facility

    $124.62

    $0.56 lower than Wyoming** for the office setting.

  • Galveston

    Texas · 19396

    Office

    $288.46

    Facility

    $124.28

    $0.26 higher than Wyoming** for the office setting.

  • Houston

    Texas · 19396

    Office

    $295.60

    Facility

    $131.42

    $7.40 higher than Wyoming** for the office setting.

  • Rest Of Texas

    Texas · 19396

    Office

    $279.73

    Facility

    $122.83

    $8.47 lower than Wyoming** for the office setting.

  • Utah

    Utah · 19396

    Office

    $277.80

    Facility

    $122.38

    $10.40 lower than Wyoming** for the office setting.

  • Virginia

    Virginia · 19396

    Office

    $284.23

    Facility

    $121.70

    $3.97 lower than Wyoming** for the office setting.

  • Virgin Islands

    United States Virgin Islands · 19396

    Office

    $293.68

    Facility

    $126.53

    $5.48 higher than Wyoming** for the office setting.

  • Vermont

    Vermont · 19396

    Office

    $283.08

    Facility

    $119.40

    $5.12 lower than Wyoming** for the office setting.

  • Rest Of Washington

    Washington · 19396

    Office

    $300.41

    Facility

    $126.31

    $12.21 higher than Wyoming** for the office setting.

  • Seattle (King Cnty)

    Washington · 19396

    Office

    $339.91

    Facility

    $137.04

    $51.71 higher than Wyoming** for the office setting.

  • Wisconsin

    Wisconsin · 19396

    Office

    $273.85

    Facility

    $115.46

    $14.35 lower than Wyoming** for the office setting.

  • West Virginia

    West Virginia · 19396

    Office

    $269.99

    Facility

    $126.31

    $18.21 lower than Wyoming** for the office setting.

See how rates vary across the country

19396 · 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.

$255.98

$345.93

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$334.651
AL$259.971
AR$255.981
AZ$283.271
CA$306.69–$385.1629
CO$302.881
CT$311.741
DC$333.871
DE$288.141
FL$289.00–$320.033
GA$271.65–$297.742
GU$314.571
HI$314.571
IA$266.081
ID$268.101
IL$280.85–$309.994
IN$269.731
KS$265.181
KY$267.421
LA$267.15–$281.102
MA$301.09–$333.362
MD$293.72–$333.873
ME$270.05–$284.912
MI$275.20–$293.252
MN$288.441
MO$262.58–$281.643
MS$259.311
MT$291.561
NC$272.971
ND$283.851
NE$267.491
NH$298.481
NJ$314.80–$330.182
NM$276.961
NV$289.621
NY$277.33–$346.555
OH$273.621
OK$266.461
OR$286.89–$312.452
PA$273.84–$303.902
PR$293.681
RI$298.381
SC$273.851
SD$282.941
TN$266.651
TX$271.97–$302.308
UT$277.801
VA$284.23–$333.872
VI$293.681
VT$283.081
WA$300.41–$339.912
WI$273.851
WV$269.991
WY$288.201

Explore 19396 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 19396 in Wyoming**, the physician’s office rate is $288.20 and the facility-setting rate is $122.87: a difference of $165.33.

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 19396 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$317.02

$288.20 × 110% = $317.02

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 19396 in Wyoming**.

PPRRVU2026_Oct_nonQPP.csv

1,710

Code
19396
Physician work
2.12
Practice expense
6.22
Malpractice
0.39

GPCI2026.csv

112

Locality
Wyoming**
Physician work
1.000
Practice expense
1.000
Malpractice
0.740
Office / nonfacility calculation for 19396 in Wyoming**
ComponentRVULocality factorAdjusted
Physician work2.12× 1.0002.1200
Practice expense6.22× 1.0006.2200
Malpractice0.39× 0.7400.2886
Total RVUs8.6286
Conversion factor× 33.4009

Office / nonfacility rate, Wyoming**$288.20

Open 19396 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work2.121
Practice expense6.221
Malpractice0.390.74

(2.12 × 1 + 6.22 × 1 + 0.39 × 0.74) × $33.4009 = $288.20

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work2.121
Practice expense1.271
Malpractice0.390.74

(2.12 × 1 + 1.27 × 1 + 0.39 × 0.74) × $33.4009 = $122.87

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

19396 · Office / nonfacility

$288.20

Effective 2026-10-01

The base rate is $30.46 higher than on 2025-10-01, moving from $257.74 to $288.20 (11.8%).

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

    $257.74changed to$288.20

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.17 changed to 2.12
    • Practice expense RVU 5.51 changed to 6.22
    • Malpractice GPCI 0.739 changed to 0.740

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $257.74

    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$288.20$122.87RVU26D
2026-07-01$288.20$122.87RVU26C
2026-04-01$288.20$122.87RVU26B
2026-01-01$288.20$122.87RVU26A
2025-10-01$257.74$136.12RVU25D
2025-07-01$257.74$136.12RVU25C
2025-04-01$257.74$136.12RVU25B
2025-01-01$257.74$136.12RVU25A

19396 billing questions

How is 19396 different from implant placement?

19396 represents custom implant design and manufacture, not the operation to place the implant. Report the applicable placement code when placement is performed.

When should 19396 be chosen over 19325?

Use 19396 for patient-specific design and manufacture of a custom implant. Code 19325 describes breast augmentation with an implant, rather than the custom-design work.

Can an implant placement code be reported with 19396?

Yes, when the custom implant is also surgically placed and the documentation supports the placement service. The design and manufacture and the operative placement describe distinct work.

What documentation supports 19396?

Document why a custom implant was needed, its patient-specific design features, and the design and manufacturing work performed. A record that only identifies selection or placement of a standard implant does not establish this service.

How should bilateral custom implant work be reported?

For a bilateral procedure reported with modifier 50, CMS pays at 150%. The record should support custom design and manufacture for both sides.

How do multiple-procedure and assistant rules affect payment?

In a same-session multiple-procedure situation, CMS pays the highest-valued procedure in full and the others at 50%. Assistant-at-surgery payment requires documented medical necessity; 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 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 19396PPRRVU2026_Oct_nonQPP.csv, line 1,710 (RVU26D)
Geographic factors for Wyoming**GPCI2026.csv, line 112 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet