No office rate
Choose 19340 for implant placement as part of breast reconstruction at the mastectomy, not for augmentation of an intact breast.
On this page
CMS RVU26D · Effective 2026-10-01
19325 Breast augmentation Medicare reimbursement rates in Oklahoma
Breast augmentation with an implant increases breast volume; report it for implant placement performed for augmentation rather than postmastectomy reconstruction. Compare 19325 office and facility rates across CMS payment localities in Oklahoma.
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 19325 in Oklahoma?
Oklahoma 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
$528.14
1 of 1 localities have a supported rate.
Payment area: Oklahoma
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 19325: Breast augmentation with implant placement
Breast augmentation with an implant increases breast volume; report it for implant placement performed for augmentation rather than postmastectomy reconstruction.
This operation increases breast volume by placing a prosthetic implant in the breast. A plastic surgeon typically performs it in a hospital outpatient department or ambulatory surgery center for a patient seeking enlargement of the breast. It is distinct from implant placement as part of breast reconstruction after mastectomy.
Report the service when the operative record supports implant placement for augmentation, rather than reconstruction or implant removal. CMS assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple procedure reduction. For bilateral augmentation reported with modifier 50, CMS pays at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 19325
- 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
- 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 RVU7.92 · 47%
- Practice expense (office) RVU7.55 · 45%
- Malpractice RVU1.48 · 9%
732
Medicare services in 2024 · #3223 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.
19325 compared with similar codes
Office rates for Oklahoma, from the same CMS release.
No office rate
Choose 19342 for implant placement in a separate procedure during breast reconstruction after mastectomy.
No office rate
This code enlarges the breast with an implant; 19316 lifts and reshapes the breast without defining implant augmentation.
No office rate
Choose 19318 for breast reduction. This code is for enlargement with an implant.
Compare 19325 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
Oklahoma →
Office / nonfacility
Unavailable
Facility
$528.14
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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 19325 in Oklahoma.
PPRRVU2026_Oct_nonQPP.csv
1,694
- Code
- 19325
- Physician work
- 7.92
- Practice expense
- 7.55
- Malpractice
- 1.48
GPCI2026.csv
86
- Locality
- Oklahoma
- Physician work
- 1.000
- Practice expense
- 0.893
- Malpractice
- 0.777
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.92 | × 1.000 | 7.9200 |
| Practice expense | 7.55 | × 0.893 | 6.7421 |
| Malpractice | 1.48 | × 0.777 | 1.1500 |
| Total RVUs | 15.8121 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Oklahoma$528.14
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.92 | 1 |
| Practice expense | 7.55 | 0.893 |
| Malpractice | 1.48 | 0.777 |
(7.92 × 1 + 7.55 × 0.893 + 1.48 × 0.777) × $33.4009 = $528.14
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.
19325 billing questions
How is this different from implant placement after mastectomy?
This code is for implant placement to enlarge the breast. Codes 19340 and 19342 describe implant placement in breast reconstruction, distinguished by whether placement occurs at the mastectomy or later.
Can a breast lift be reported in the same session?
Code 19316 may be reported when a breast lift is also performed and documented as a separate service. The operative note should describe both the implant augmentation and the lift.
How should bilateral augmentation be reported?
Use modifier 50 for a bilateral procedure. CMS pays bilateral reporting at 150%.
What happens when another procedure is performed during the same session?
Under the standard multiple procedure reduction, CMS pays the highest-valued procedure in full and pays the other procedure or procedures at 50%.
What documentation supports assistant-at-surgery payment?
The record must document the medical necessity of the assistant's participation. CMS does not permit co-surgeons or team surgery for this code.
Which postoperative services are 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.
1,69119307,,Mast mod rad,A,,17.54,11.66,NA,11.66,,4.53,33.73,33.73,0,090,0.10,0.71,0.19,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,69219316,,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
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193