# CPT 19364: Breast reconstruction with free flap

Medicare CPT 19364 pays $2,369.46 in a non-facility setting and $2,369.46 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $2,139.79 in Arkansas to $2,990.59 in Alaska, a 40% spread.

Web page: https://www.med-reveal.com/rates/19364-cpt-fee-schedule
Section: Surgery and Procedures
Billed by: Plastic Surgery

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $2,369.46 |
| National facility | $2,369.46 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $2,990.59 | $2,990.59 |
| Florida | $2,622.60 | $2,622.60 |
| New York | $2,613.42 | $2,613.42 |
| District of Columbia | $2,602.04 | $2,602.04 |
| Illinois | $2,591.38 | $2,591.38 |
| New Jersey | $2,553.18 | $2,553.18 |
| Connecticut | $2,508.09 | $2,508.09 |
| Washington | $2,457.75 | $2,457.75 |
| Massachusetts | $2,456.18 | $2,456.18 |
| Maryland | $2,438.52 | $2,438.52 |
| Michigan | $2,433.61 | $2,433.61 |
| California | $2,429.48 | $2,429.48 |
| Rhode Island | $2,390.89 | $2,390.89 |
| Georgia | $2,390.57 | $2,390.57 |
| West Virginia | $2,389.59 | $2,389.59 |
| Pennsylvania | $2,385.50 | $2,385.50 |
| Colorado | $2,374.03 | $2,374.03 |
| Puerto Rico | $2,373.38 | $2,373.38 |
| Virgin Islands | $2,373.38 | $2,373.38 |
| Montana | $2,368.93 | $2,368.93 |
| New Hampshire | $2,365.78 | $2,365.78 |
| New Mexico | $2,363.12 | $2,363.12 |
| Hawaii | $2,356.29 | $2,356.29 |
| Texas | $2,347.12 | $2,347.12 |
| Oregon | $2,345.72 | $2,345.72 |
| Delaware | $2,341.03 | $2,341.03 |
| Nevada | $2,325.94 | $2,325.94 |
| Louisiana | $2,319.46 | $2,319.46 |
| Ohio | $2,309.13 | $2,309.13 |
| Arizona | $2,309.07 | $2,309.07 |
| Missouri | $2,306.21 | $2,306.21 |
| Wyoming | $2,300.59 | $2,300.59 |
| Utah | $2,299.38 | $2,299.38 |
| Virginia | $2,279.39 | $2,279.39 |
| South Carolina | $2,275.18 | $2,275.18 |
| Kentucky | $2,267.27 | $2,267.27 |
| Maine | $2,238.59 | $2,238.59 |
| Oklahoma | $2,233.59 | $2,233.59 |
| Vermont | $2,231.44 | $2,231.44 |
| North Carolina | $2,225.75 | $2,225.75 |
| North Dakota | $2,212.13 | $2,212.13 |
| Minnesota | $2,203.81 | $2,203.81 |
| Mississippi | $2,200.56 | $2,200.56 |
| South Dakota | $2,193.59 | $2,193.59 |
| Tennessee | $2,181.51 | $2,181.51 |
| Indiana | $2,180.92 | $2,180.92 |
| Idaho | $2,172.45 | $2,172.45 |
| Kansas | $2,169.18 | $2,169.18 |
| Alabama | $2,164.78 | $2,164.78 |
| Wisconsin | $2,156.02 | $2,156.02 |
| Nebraska | $2,149.44 | $2,149.44 |
| Iowa | $2,148.73 | $2,148.73 |
| Arkansas | $2,139.79 | $2,139.79 |

## 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 19364 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