CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 19350 RVU and Medicare Payment (2026)
Nipple/areola reconstruction — 8.88 work RVU, about $893.81 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 8.88
- PE RVU (non-facility)
- 16.21
- PE RVU (facility)
- 7.89
- MP RVU
- 1.67
- Office payment
- $893.81
- Facility payment
- $615.91
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 19350 in a non-facility setting with national GPCI: (8.88 + 16.21 + 1.67) × $33.4009 ≈ $893.81. The same code in a facility setting pays about $615.91 because facility PE RVU (7.89) replaces office PE RVU.
What changes by locality
GPCI moves 19350 non-facility payment from $790.41 to $1,139.86 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 19350?
8.88. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 19350 in 2026?
About $893.81 non-facility ($615.91 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (8.88) and malpractice RVU stay fixed; only practice expense changes (16.21 office vs 7.89 facility). That is the entire office-vs-facility payment gap.