CPT 19318

Breast Reduction

CPT 19318 pays $980.32 in a non-facility setting and $980.32 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $881.69 in Arkansas to $1,220.31 in Alaska, a 38% spread.

National non-facility rate

$980.32

Office and other outpatient settings

Facility rate
$980.32

Hospital and ASC settings

Highest state
$1,220.31

Alaska

Lowest state
$881.69

Arkansas · 38% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $980.32
CPT 19318 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $980.32, national facility $980.32.
StateRate compared visuallyNon-facilityFacility
Alaska
$1,220.31$1,220.31
District of Columbia
$1,083.65$1,083.65
New York
$1,082.16$1,082.16
Florida
$1,075.11$1,075.11
New Jersey
$1,060.64$1,060.64
Illinois
$1,060.08$1,060.08
Connecticut
$1,039.19$1,039.19
Washington
$1,026.22$1,026.22
Massachusetts
$1,024.11$1,024.11
California
$1,019.64$1,019.64
Maryland
$1,010.04$1,010.04
Michigan
$998.68$998.68
Rhode Island
$991.42$991.42
Colorado
$987.93$987.93
Hawaii
$987.93$987.93
Pennsylvania
$984.47$984.47
Georgia
$983.99$983.99
Puerto Rico
$982.79$982.79
Virgin Islands
$982.79$982.79
New Hampshire
$982.69$982.69
Montana
$980.12$980.12
Oregon
$976.38$976.38
West Virginia
$975.85$975.85
Texas
$970.59$970.59
New Mexico
$970.36$970.36
Delaware
$968.63$968.63
Nevada
$964.17$964.17
Arizona
$954.94$954.94
Wyoming
$954.61$954.61
Louisiana
$953.70$953.70
Ohio
$949.84$949.84
Missouri
$949.18$949.18
Utah
$948.67$948.67
Virginia
$945.14$945.14
South Carolina
$938.17$938.17
Kentucky
$932.02$932.02
Vermont
$927.88$927.88
Maine
$927.40$927.40
North Dakota
$921.59$921.59
Minnesota
$921.14$921.14
North Carolina
$920.55$920.55
Oklahoma
$919.81$919.81
South Dakota
$914.67$914.67
Mississippi
$904.56$904.56
Indiana
$903.26$903.26
Tennessee
$901.84$901.84
Idaho
$899.46$899.46
Wisconsin
$896.81$896.81
Kansas
$896.78$896.78
Alabama
$892.48$892.48
Nebraska
$891.15$891.15
Iowa
$890.15$890.15
Arkansas
$881.69$881.69

Billed by 1 specialties

Commercial rates for 19318

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates