CPT 19370
Global 090 ActiveRevj peri-implt capsule brst
CPT 19370 Billing & Documentation Guide
CPT code 19370 (Revj peri-implt capsule brst) is classified under Anesthesia with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 8.94, a non-facility practice expense RVU of 7.82, and a malpractice RVU of 1.68, a total non-facility RVU of 18.44 and facility RVU of 18.44. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $625.33, though rates vary from $551.87 to $757 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 19370, 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 19370 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 19370 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 19370
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 8.94 | 8.94 |
| Practice Expense RVU | 7.82 | 7.82 |
| Malpractice RVU | 1.68 | 1.68 |
| Total RVU | 18.44 | 18.44 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 19370
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 | $648.8 | $648.8 | $620.03 - $738.17 | 29 |
| Florida | $669.91 | $669.91 | $632.65 - $712.42 | 3 |
| Georgia | $615.38 | $615.38 | $598.48 - $632.27 | 2 |
| Illinois | $659.26 | $659.26 | $624.78 - $691.98 | 4 |
| Michigan | $622.85 | $622.85 | $600.43 - $645.26 | 2 |
| North Carolina | $578.16 | $578.16 | $578.16 - $578.16 | 1 |
| New York | $680.44 | $680.44 | $586.19 - $732.48 | 5 |
| Ohio | $593.64 | $593.64 | $593.64 - $593.64 | 1 |
| Pennsylvania | $617.12 | $617.12 | $591.41 - $642.83 | 2 |
| Texas | $609.52 | $609.52 | $588.42 - $637.57 | 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 19370
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 19370 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 |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 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 |
Frequently Asked Questions, CPT 19370
What does CPT code 19370 mean? +
CPT code 19370 represents: Revj peri-implt capsule brst. It's in the Anesthesia category with a global period of 090.
What is the Medicare reimbursement for CPT 19370? +
The 2026 Medicare national average non-facility payment for CPT 19370 is $625.33. Rates range from $551.87 to $757 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 19370? +
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 19370? +
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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