CPT 19340
Global 090 ActiveInsj breast implt sm d mast
CPT 19340 Billing & Documentation Guide
CPT code 19340 (Insj breast implt sm d mast) is classified under Anesthesia with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 10.22, a non-facility practice expense RVU of 8.76, and a malpractice RVU of 2.01, a total non-facility RVU of 20.99 and facility RVU of 20.99. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $711.16, though rates vary from $627.27 to $860.64 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 19340, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 19340 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 19340 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 19340
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 10.22 | 10.22 |
| Practice Expense RVU | 8.76 | 8.76 |
| Malpractice RVU | 2.01 | 2.01 |
| Total RVU | 20.99 | 20.99 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 19340
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $736.22 | $736.22 | $703.83 - $836.81 | 29 |
| Florida | $765.61 | $765.61 | $721.98 - $815.73 | 3 |
| Georgia | $701.33 | $701.33 | $682.38 - $720.28 | 2 |
| Illinois | $753.57 | $753.57 | $713.43 - $791.88 | 4 |
| Michigan | $710.6 | $710.6 | $684.29 - $736.9 | 2 |
| North Carolina | $657.25 | $657.25 | $657.25 - $657.25 | 1 |
| New York | $775.23 | $775.23 | $666.52 - $835.77 | 5 |
| Ohio | $676.17 | $676.17 | $676.17 - $676.17 | 1 |
| Pennsylvania | $702.79 | $702.79 | $673.4 - $732.18 | 2 |
| Texas | $693.65 | $693.65 | $669.98 - $727.01 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 19340
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 19340 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 00400 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0905T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11000 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11001 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11004 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11005 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11006 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11042 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 19340
What does CPT code 19340 mean? +
CPT code 19340 represents: Insj breast implt sm d mast. It's in the Anesthesia category with a global period of 090.
What is the Medicare reimbursement for CPT 19340? +
The 2026 Medicare national average non-facility payment for CPT 19340 is $711.16. Rates range from $627.27 to $860.64 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 19340? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 19340? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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