# CPT 19357: Breast reconstruction, immediate/delayed, with tissue expander

Medicare CPT 19357 pays $1,072.84 in a non-facility setting and $1,072.84 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $958.46 in Arkansas to $1,306.11 in Alaska, a 36% spread.

Web page: https://www.med-reveal.com/rates/19357-cpt-fee-schedule
Section: Surgery and Procedures
Billed by: Plastic Surgery

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $1,072.84 |
| National facility | $1,072.84 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $1,306.11 | $1,306.11 |
| District of Columbia | $1,197.97 | $1,197.97 |
| New York | $1,186.06 | $1,186.06 |
| New Jersey | $1,168.05 | $1,168.05 |
| Florida | $1,160.50 | $1,160.50 |
| Illinois | $1,140.46 | $1,140.46 |
| Connecticut | $1,139.98 | $1,139.98 |
| California | $1,139.97 | $1,139.97 |
| Washington | $1,138.71 | $1,138.71 |
| Massachusetts | $1,133.98 | $1,133.98 |
| Maryland | $1,107.35 | $1,107.35 |
| Hawaii | $1,102.91 | $1,102.91 |
| Colorado | $1,090.66 | $1,090.66 |
| Rhode Island | $1,088.66 | $1,088.66 |
| New Hampshire | $1,081.93 | $1,081.93 |
| Michigan | $1,079.44 | $1,079.44 |
| Oregon | $1,078.26 | $1,078.26 |
| Puerto Rico | $1,076.96 | $1,076.96 |
| Virgin Islands | $1,076.96 | $1,076.96 |
| Pennsylvania | $1,073.24 | $1,073.24 |
| Montana | $1,072.66 | $1,072.66 |
| Georgia | $1,068.47 | $1,068.47 |
| Texas | $1,061.30 | $1,061.30 |
| Delaware | $1,060.09 | $1,060.09 |
| Nevada | $1,058.16 | $1,058.16 |
| New Mexico | $1,049.71 | $1,049.71 |
| Wyoming | $1,049.22 | $1,049.22 |
| West Virginia | $1,046.67 | $1,046.67 |
| Arizona | $1,044.30 | $1,044.30 |
| Virginia | $1,037.65 | $1,037.65 |
| Louisiana | $1,033.72 | $1,033.72 |
| Utah | $1,033.65 | $1,033.65 |
| Missouri | $1,030.36 | $1,030.36 |
| Ohio | $1,030.18 | $1,030.18 |
| Minnesota | $1,023.34 | $1,023.34 |
| Vermont | $1,022.97 | $1,022.97 |
| South Carolina | $1,021.31 | $1,021.31 |
| North Dakota | $1,018.87 | $1,018.87 |
| Maine | $1,016.71 | $1,016.71 |
| South Dakota | $1,012.51 | $1,012.51 |
| Kentucky | $1,009.76 | $1,009.76 |
| North Carolina | $1,006.63 | $1,006.63 |
| Oklahoma | $999.22 | $999.22 |
| Indiana | $989.74 | $989.74 |
| Wisconsin | $989.02 | $989.02 |
| Tennessee | $985.39 | $985.39 |
| Idaho | $985.06 | $985.06 |
| Kansas | $979.90 | $979.90 |
| Mississippi | $979.81 | $979.81 |
| Nebraska | $977.93 | $977.93 |
| Iowa | $975.67 | $975.67 |
| Alabama | $971.07 | $971.07 |
| Arkansas | $958.46 | $958.46 |

## 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 19357 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