No office rate
19328 is for an intact implant; 19330 is for removal of a ruptured implant.
On this page
CMS RVU26D · Effective 2026-10-01
19328 Implant removal Medicare reimbursement rates in Iowa
Reports surgical removal of an intact breast implant, such as explantation without rupture or removal during a change in a reconstruction plan. Compare 19328 office and facility rates across CMS payment localities in Iowa.
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.
What does Medicare pay for 19328 in Iowa?
Iowa has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$466.10
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Breast surgery
About 19328: Removal of intact breast implant
Reports surgical removal of an intact breast implant, such as explantation without rupture or removal during a change in a reconstruction plan.
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.
CMS billing rules for 19328
- 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 RVU7.25 · 47%
- Practice expense (office) RVU6.72 · 44%
- Malpractice RVU1.40 · 9%
1.8K
Medicare services in 2024 · #2560 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.
19328 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
19371 describes complete periprosthetic capsulectomy and includes implant removal. Use 19328 for intact implant removal without that complete capsulectomy service.
No office rate
19328 reports removal; 19342 describes replacement implant placement in a setting separate from mastectomy.
No office rate
19325 describes implant placement for breast augmentation, rather than removal of an existing intact implant.
Compare 19328 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Iowa →
Office / nonfacility
Unavailable
Facility
$466.10
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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 19328 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
1,695
- Code
- 19328
- Physician work
- 7.25
- Practice expense
- 6.72
- Malpractice
- 1.40
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.25 | × 1.000 | 7.2500 |
| Practice expense | 6.72 | × 0.915 | 6.1488 |
| Malpractice | 1.40 | × 0.397 | 0.5558 |
| Total RVUs | 13.9546 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$466.10
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.25 | 1 |
| Practice expense | 6.72 | 0.915 |
| Malpractice | 1.4 | 0.397 |
(7.25 × 1 + 6.72 × 0.915 + 1.4 × 0.397) × $33.4009 = $466.10
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.
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 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.
1,69219316,,Mastopexy,A,,10.81,8.89,NA,8.89,,2.13,21.83,21.83,0,090,0.10,0.71,0.19,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,69319318,,Breast reduction,A,,15.63,10.76,NA,10.76,,2.96,29.35,29.35,0,090,0.10,0.71,0.19,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,69419325,,Breast augmentation w/implt,A,,7.92,7.55,NA,7.55,,1.48,16.95,16.95,0,090,0.10,0.71,0.19,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,69519328,,Rmvl intact breast implant,A,,7.25,6.72,NA,6.72,,1.40,15.37,15.37,0,090,0.10,0.71,0.19,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,69619330,,Rmvl ruptured breast implant,A,,8.78,7.27,NA,7.27,,1.69,17.74,17.74,0,090,0.10,0.71,0.19,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,69719340,,Insj breast implt sm d mast,A,,10.22,8.76,NA,8.76,,2.01,20.99,20.99,0,090,0.10,0.71,0.19,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,69819342,,Insj/rplcmt brst implt sep d,A,,10.22,8.66,NA,8.66,,1.91,20.79,20.79,0,090,0.10,0.71,0.19,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136