Billing code 19355: Nipple correctionMedicare rate & RVUs in Nevada
Corrects an inverted nipple by surgery when eversion is the operative goal, rather than reconstruction of a missing nipple or broader breast surgery.
Medicare pays $805.93 for 19355 in the office in Nevada (Nevada**). Which amount applies depends on the service address.
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 19355 covers
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.
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 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | $805.93 | $553.84 |
How the 19355 rate is calculated
Each of 19355’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 · 19355
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.31Practice expense 14.53Malpractice 1.53
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 19355
19355 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 19355
Nipple correction
| 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) | 0 | Not paid without supporting documentation. |
| 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 · 19355
Nipple correction
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
19355 without 50 · national office
$813.98
Nipple correction
19355-50 · Bilateral: 150%
$1,220.97
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).
19355 compared with similar codes
Compare codes
19355 vs 19350 vs 19316 vs 19318: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 19350Nipple reconstruction
- 19355 corrects inversion of an existing nipple. 19350 addresses nipple or areola reconstruction, such as when the nipple is absent.
- 19316Breast lift
- 19316 is a breast lift for ptosis. It is not the code for an operation whose goal is correction of nipple inversion.
- 19318Breast reduction
- 19318 addresses breast reduction. Choose 19355 when the operative target is an inverted nipple, not breast size.
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 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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