Billing code 19328: Implant removalMedicare rate & RVUs in Florida
Reports surgical removal of an intact breast implant, such as explantation without rupture or removal during a change in a reconstruction plan.
CMS doesn’t publish an office rate for 19328 in Florida.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 19328 covers
This service is surgical removal of a breast implant that is intact when removed. Plastic surgeons and breast surgeons commonly perform it for explantation or as part of a change in a breast reconstruction plan, in an operating room or another appropriately equipped setting. The operative report should identify the implant and side, confirm its condition, and describe the removal and any capsule work performed.
Choose this code when the implant is intact; use the ruptured-implant code when it is ruptured. Complete periprosthetic capsulectomy has a separate code that includes implant removal, so review the documented capsule work before reporting removal separately. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. 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 others at 50%. Assistant-at-surgery payment is statutorily restricted; 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 19328 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $554.07 |
| Miami | Unavailable | $594.07 |
| Rest Of Florida | Unavailable | $527.02 |
How the 19328 rate is calculated
Each of 19328’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 · 19328
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.25Practice expense 6.72Malpractice 1.40
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 19328
19328 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 19328
Implant removal
| 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 · 19328
Implant removal
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
19328 without 50 · national facility
$513.37
Implant removal
19328-50 · Bilateral: 150%
$770.06
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).
19328 compared with similar codes
Compare codes
19328 vs 19330 vs 19371 vs 19342 vs 19325: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 19330Implant removal
- 19328 is for an intact implant; 19330 is for removal of a ruptured implant.
- 19371Capsulectomy
- 19371 describes complete periprosthetic capsulectomy and includes implant removal. Use 19328 for intact implant removal without that complete capsulectomy service.
- 19342Breast implant
- 19328 reports removal; 19342 describes replacement implant placement in a setting separate from mastectomy.
- 19325Breast augmentation
- 19325 describes implant placement for breast augmentation, rather than removal of an existing intact implant.
19328 billing questions
How does this differ from removal of a ruptured implant?
Use this code when the implant is intact at removal. The related ruptured-implant code, 19330, describes removal when the implant is ruptured.
Can this be reported with complete capsulectomy?
Code 19371 describes complete periprosthetic capsulectomy and includes implant removal. Review the operative report before separately reporting 19328 for the same removal.
What if a new implant is placed during the same operation?
Code 19342 may describe replacement implant placement when performed separately from mastectomy. Document both the removal and replacement work, and apply the same-session multiple-procedure payment rule.
How is bilateral removal reported under the CMS facts?
For bilateral procedures reported with modifier 50, CMS pays at 150%. Document removal on both sides.
What postoperative care is included?
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 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
Show the CMS file lines behind this rate
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