No office rate
Choose 19330 for removal of a ruptured implant and 19328 for removal of an intact implant.
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CMS RVU26D · Effective 2026-10-01
19330 Implant removal Medicare reimbursement rates in Kentucky
Reports surgical removal of a ruptured breast implant, such as an implant found to have failed before or during an explantation procedure. Compare 19330 office and facility rates across CMS payment localities in Kentucky.
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 19330 in Kentucky?
Kentucky 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
$560.78
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 19330: Removal of ruptured breast implant
Reports surgical removal of a ruptured breast implant, such as an implant found to have failed before or during an explantation procedure.
This code describes surgical explantation when a breast implant is ruptured. Plastic surgeons and breast surgeons commonly perform the procedure in an operating room for a patient with a known or suspected implant failure, including rupture confirmed during surgery. The operative record should identify the affected side, the implant’s ruptured status, and the removal performed; documenting whether one or both implants were removed helps support the claim.
Report this code for the ruptured implant, rather than the intact-implant removal code. If a new implant is placed or capsule surgery is also performed, document those services separately and select the applicable code for the work performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, 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%. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 19330
- 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 RVU8.78 · 49%
- Practice expense (office) RVU7.27 · 41%
- Malpractice RVU1.69 · 10%
1.5K
Medicare services in 2024 · #2657 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.
19330 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
19330 describes removal of the ruptured implant; 19371 describes complete removal of the surrounding periprosthetic capsule.
No office rate
19342 describes insertion or replacement of an implant. It does not identify removal of a ruptured implant.
Compare 19330 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$560.78
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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 19330 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
1,696
- Code
- 19330
- Physician work
- 8.78
- Practice expense
- 7.27
- Malpractice
- 1.69
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.78 | × 1.000 | 8.7800 |
| Practice expense | 7.27 | × 0.889 | 6.4630 |
| Malpractice | 1.69 | × 0.915 | 1.5464 |
| Total RVUs | 16.7894 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$560.78
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.78 | 1 |
| Practice expense | 7.27 | 0.889 |
| Malpractice | 1.69 | 0.915 |
(8.78 × 1 + 7.27 × 0.889 + 1.69 × 0.915) × $33.4009 = $560.78
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.
19330 billing questions
How does this differ from removal of an intact implant?
Use this code when the implant being removed is ruptured. The intact-implant removal code is the alternative when the implant is not ruptured.
Does this code include removal of the surrounding capsule?
This code identifies removal of the ruptured implant. If a separate capsule procedure is performed, document the extent and nature of that work for code selection.
Can a replacement implant be reported at the same operation?
If a new implant is placed, document that work separately and evaluate the applicable insertion or replacement code, such as 19342, based on the circumstances.
How should bilateral ruptured implant removal be reported?
When both sides are treated, report bilateral surgery with modifier 50; CMS pays this procedure at 150% under the stated rule.
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.
1,69319318,,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
1,69919350,,Nipple/areola reconstruction,A,,8.88,16.21,,7.89,,1.67,26.76,18.44,0,090,0.10,0.71,0.19,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631