# CPT 19342: Delayed insertion of breast prosthesis

Medicare CPT 19342 pays $694.40 in a non-facility setting and $694.40 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $622.68 in Arkansas to $855.24 in Alaska, a 37% spread.

Web page: https://www.med-reveal.com/rates/19342-cpt-fee-schedule
Section: Surgery and Procedures
Billed by: Plastic Surgery

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $694.40 |
| National facility | $694.40 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $855.24 | $855.24 |
| District of Columbia | $771.53 | $771.53 |
| New York | $766.96 | $766.96 |
| Florida | $755.76 | $755.76 |
| New Jersey | $753.70 | $753.70 |
| Illinois | $743.96 | $743.96 |
| Connecticut | $736.90 | $736.90 |
| Washington | $732.20 | $732.20 |
| California | $730.45 | $730.45 |
| Massachusetts | $729.88 | $729.88 |
| Maryland | $716.08 | $716.08 |
| Hawaii | $707.17 | $707.17 |
| Rhode Island | $703.55 | $703.55 |
| Colorado | $703.04 | $703.04 |
| Michigan | $702.76 | $702.76 |
| New Hampshire | $698.29 | $698.29 |
| Puerto Rico | $696.63 | $696.63 |
| Virgin Islands | $696.63 | $696.63 |
| Pennsylvania | $695.95 | $695.95 |
| Oregon | $694.97 | $694.97 |
| Montana | $694.28 | $694.28 |
| Georgia | $694.15 | $694.15 |
| Texas | $687.26 | $687.26 |
| Delaware | $686.20 | $686.20 |
| Nevada | $684.04 | $684.04 |
| West Virginia | $684.01 | $684.01 |
| New Mexico | $683.22 | $683.22 |
| Wyoming | $677.82 | $677.82 |
| Arizona | $676.25 | $676.25 |
| Louisiana | $672.24 | $672.24 |
| Virginia | $670.73 | $670.73 |
| Utah | $670.54 | $670.54 |
| Ohio | $669.75 | $669.75 |
| Missouri | $669.59 | $669.59 |
| South Carolina | $662.85 | $662.85 |
| Vermont | $660.00 | $660.00 |
| Minnesota | $657.88 | $657.88 |
| Maine | $657.71 | $657.71 |
| Kentucky | $656.88 | $656.88 |
| North Dakota | $656.51 | $656.51 |
| South Dakota | $652.04 | $652.04 |
| North Carolina | $651.99 | $651.99 |
| Oklahoma | $649.23 | $649.23 |
| Indiana | $640.50 | $640.50 |
| Tennessee | $638.55 | $638.55 |
| Wisconsin | $638.11 | $638.11 |
| Idaho | $637.64 | $637.64 |
| Mississippi | $637.55 | $637.55 |
| Kansas | $634.99 | $634.99 |
| Nebraska | $632.45 | $632.45 |
| Iowa | $631.35 | $631.35 |
| Alabama | $630.56 | $630.56 |
| Arkansas | $622.68 | $622.68 |

## Related codes

- 19000: Puncture aspiration of cyst of breast — https://www.med-reveal.com/rates/19000-cpt-fee-schedule
- 19020: Mastotomy with exploration or drainage of abscess — https://www.med-reveal.com/rates/19020-cpt-fee-schedule
- 19081: Biopsy, breast, with placement of localization device, stereotactic guidance, first lesion — https://www.med-reveal.com/rates/19081-cpt-fee-schedule
- 19083: Biopsy, breast, with placement of localization device, ultrasound guidance, first lesion — https://www.med-reveal.com/rates/19083-cpt-fee-schedule
- 19100: Biopsy of breast, percutaneous, needle core — https://www.med-reveal.com/rates/19100-cpt-fee-schedule
- 19120: Excision of cyst/fibroadenoma/lesion of breast — https://www.med-reveal.com/rates/19120-cpt-fee-schedule
- 19301: Mastectomy, partial (lumpectomy) — https://www.med-reveal.com/rates/19301-cpt-fee-schedule
- 19303: Mastectomy, simple, complete — https://www.med-reveal.com/rates/19303-cpt-fee-schedule

Commercial negotiated rates for 19342 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules